Novo Nordisk this week unveiled an ambitious strategy aimed at reigniting growth beyond its flagship injections Wegovy and Ozempic, but the road back to winning investors and reclaiming share in the obesity drug market remains steep.
Meanwhile, Eli Lilly (LLY) continues to erode Novo Nordisk A/S (NVO)'s market position, including in the fast-growing oral weight-loss segment.
As Novo Nordisk A/S (NVO) struggles to reverse its fortunes, some analysts believe Eli Lilly (LLY) holds multiple advantages that should cement its leadership in the obesity drug market. Whenever Novo Nordisk urges investors to look to the future, Eli Lilly manages to produce fresh evidence that the Danish drugmaker's lead is steadily narrowing.
Novo Nordisk released a strategy this week seeking to restart growth beyond its flagship injectables Wegovy and Ozempic, both of which face patent expiration in major markets in the early 2030s. At its capital markets day on Monday, the company unveiled a pipeline of potential blockbuster candidates, diversifying its research focus beyond the two core areas of obesity and diabetes.
But Wall Street is not buying Novo Nordisk's roadmap. The company's growth targets merely match the industry average rather than delivering outsized growth, disappointing investors and sending the stock sharply lower. Markets are also uneasy about the lack of a clear short-term turnaround plan.
Over the same period, Eli Lilly (LLY) has kept taking share from its rival, including in the booming oral weight-loss segment. Novo Nordisk's oral Wegovy pill reached the market first, months ahead of Eli Lilly (LLY)'s rival Foundayo, and the company hopes to defend that first-mover advantage in oral weight loss.
Novo Nordisk CEO Mike Doustdar said in an interview on Tuesday that early usage patterns show many patients have been waiting for an alternative to injections. "If that trend continues at its current pace, then based on the data, oral drugs will account for more than half of usage by the late 2030s."
Yet Eli Lilly (LLY) is closing in fast with its formidable commercial muscle. On Monday, Eli Lilly (LLY) CEO Dave Ricks said in an interview that the company's new oral obesity drug Foundayo is steadily penetrating the U.S. market. Ricks told reporters in Houston, Texas, that one-third of new GLP-1 oral drug patients are choosing Eli Lilly (LLY)'s product, and its share of the oral market is "rising every week."
Since July, U.S. federal Medicare has covered obesity drugs, and Eli Lilly (LLY) has also gained a first-mover advantage in this emerging reimbursement market. Ricks said that after Medicare coverage took effect, 70% of new Medicare patients chose Eli Lilly (LLY)'s drugs. He added that Medicare patients are particularly drawn to Eli Lilly (LLY)'s weight-loss injection Zepbound, which has helped Eli Lilly (LLY) dominate the overall market.
Eli Lilly (LLY) disclosed in August that its second-quarter U.S. GLP-1 market share was about 61%, versus about 39% for Novo Nordisk A/S (NVO).
At Monday's investor meeting, shareholders wanted more detail from Novo Nordisk A/S (NVO) on its growth plans beyond Wegovy and Ozempic, and the drugmaker is betting that more than one successor product could emerge from its blockbuster portfolio.
For Novo Nordisk A/S (NVO), the challenge is not only filling the revenue gap once the two flagship drugs lose patent protection and face heavy generic competition; it must also convince investors that it can regain growth momentum in the GLP-1 market it pioneered, even as its rival keeps pulling ahead.
Eli Lilly (LLY) is likely to maintain its dominant position. Despite two consecutive years of multiple setbacks and a difficult self-rescue effort, analysts believe Eli Lilly (LLY) has several advantages that should keep it at the top of the obesity drug market.
"Eli Lilly (LLY) is currently in the lead. Backed by strong commercialization capabilities, a global product rollout footprint and a cutting-edge pipeline of candidates, we believe it will continue to hold its lead," Leerink Partners analyst David Risinger said in an interview.
Risinger expects Foundayo's share of the oral GLP-1 market to keep climbing, citing Eli Lilly (LLY)'s exceptionally strong commercialization capabilities and higher marketing spend. He also believes Foundayo could eventually dominate the global oral obesity drug market, partly because its production costs are expected to be lower than Wegovy's oral tablet at large scale.
Foundayo is a small-molecule drug, making manufacturing and scale-up less difficult than peptide-based drugs such as Novo Nordisk A/S (NVO)'s oral Wegovy pill and existing injectable GLP-1 drugs. Although Foundayo's average weight loss is weaker than oral Wegovy, it requires no dietary or fluid restrictions, which appeals to some patients.
Novo Nordisk A/S (NVO) executives did not directly address this week whether Foundayo is easier to scale up. The company is investing billions of dollars in manufacturing sites, with executives saying the goal is to increase the number of patients using GLP-1 drugs tenfold by 2030. Management has repeatedly stressed that supply is no longer a problem and that the shortages seen in the early days of Ozempic and Wegovy injections will not recur.
In the injectable segment, Zepbound delivers better weight loss than earlier-dose versions of Wegovy, a key reason Eli Lilly (LLY) has been able to take share from Novo Nordisk A/S (NVO). Novo Nordisk launched a higher-dose version of Wegovy this year to narrow the efficacy gap, with the new version's weight loss roughly comparable to Zepbound.
But Eli Lilly (LLY) has not stood still. Risinger said Eli Lilly (LLY) has a next-generation obesity pipeline that could extend its lead beyond Zepbound and Foundayo. That includes retatrutide, a triple agonist targeting three gut hormones that has shown better weight loss than existing obesity drugs in clinical trials; Eli Lilly (LLY) plans to submit a marketing application for the drug in the first quarter of 2027.
Eli Lilly (LLY) is also developing a weekly injectable targeting the amylin receptor, a pathway that regulates appetite and satiety and differs from the targets of existing drugs. Risinger said the drug's potential far exceeds current market expectations, especially for the large group of patients who cannot tolerate GLP-1 drugs or respond poorly to them. "We are very bullish on Eli Lilly (LLY)'s pipeline of successors to Zepbound and Foundayo."
While investors focus heavily on the weight-loss data for next-generation drugs from Novo Nordisk A/S (NVO) and Eli Lilly (LLY), Novo Nordisk A/S (NVO) predicts the future market will become more segmented. Novo Nordisk A/S (NVO) Chief Scientific Officer Martin Holst Lange told reporters this week that a rich future pipeline will give doctors and patients more choices and boost drug penetration. The company is studying new drugs across dimensions including tolerability, muscle preservation, obesity-related comorbidities and ease of use. "A single drug cannot achieve all of these goals."
Novo Nordisk A/S (NVO) Bets on Next-Generation Pipeline. Novo Nordisk A/S (NVO) CEO Mike Doustdar, left, and Eli Lilly (LLY) CEO Dave Ricks at a White House Oval Office event on weight-loss drugs on Nov. 6, 2025.
Facing Eli Lilly (LLY)'s strong lead, Novo Nordisk A/S (NVO)'s response is an all-in bet on next-generation drugs. Novo Nordisk A/S (NVO) aims to launch more than five potential blockbusters before 2030 and to generate more than 150 billion Danish kroner (about $23 billion) in pipeline drug sales by 2035. The company plans to maintain at least five Phase 3 programs in obesity and diabetes, plus five Phase 3 programs in other therapeutic areas, diversifying its pipeline.
This ambitious plan reflects the crisis Novo Nordisk A/S (NVO) urgently needs to solve: patent protection for semaglutide, the active ingredient in Wegovy and Ozempic, runs through 2032; the two drugs account for about two-thirds of Novo Nordisk A/S (NVO)'s revenue, with combined 2025 sales of $31 billion. Novo Nordisk A/S (NVO) must convince investors that its new drug pipeline can fill the revenue gap once generics enter. And after a string of pipeline setbacks, the company's stock has been under pressure and falling for years.
Among the products the company is counting on is CagriSema, a combination of semaglutide and cagrilintide that targets amylin, expected to launch early next year; it will be followed by standalone cagrilintide, a higher-dose CagriSema in 2028 and other new obesity drugs. Wall Street's enthusiasm for CagriSema is limited after the drug's weight-loss results in clinical trials fell short of expectations. But Novo Nordisk A/S (NVO) insists CagriSema has strong efficacy and enough differentiation to be commercially viable.
Lange told reporters that individualized dosing may be the breakthrough path for this potential blockbuster, and the company released new late-stage data this week: a head-to-head trial showed CagriSema delivered better weight loss than tirzepatide, the active ingredient in Eli Lilly (LLY)'s Zepbound and Mounjaro, in patients with type 2 diabetes. However, the results have limitations: both drug doses used in the trial were low, and in head-to-head studies using higher doses, tirzepatide delivered better weight loss than CagriSema.
At the same time, Novo Nordisk A/S (NVO) remains bullish on growth in the oral obesity drug market. Doustdar said in an interview that investors should not focus only on market share in the future, because the overall size of the market matters just as much, and the obesity drug market still has enormous room to grow. Novo Nordisk A/S (NVO) plans to expand manufacturing capacity so that by 2030 it can support 15 million oral weight-loss drug users. The company says oral drugs could eventually capture half of the global weight-loss drug market. Its oral Wegovy tablet has reached 7 million prescriptions in the U.S., with 90% of sales coming from self-pay channels.
But the problem is that investors want more than a promising pipeline. On Monday, analysts pressed Novo Nordisk A/S (NVO) executives on pricing assumptions: once Wegovy and Ozempic patents expire, can pipeline successors still command high prices? Novo Nordisk A/S (NVO)'s 2026-2030 revenue guidance implies growth only in line with peer drugmakers, making it hard to recreate the explosive growth of the Wegovy and Ozempic era.
Novo Nordisk A/S (NVO) is therefore caught in a difficult balancing act: fighting Eli Lilly (LLY) to defend its existing obesity drug base while continuing to invest in next-generation drugs to replace current products.
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