The launch of weight-loss pills is the hottest battle in pharma. So far, Eli Lilly is losing to rival Novo Nordisk.
Since its obesity pill Foundayo hit the market in April, Lilly has captured about 11% of the prescription volume for new pills, according to the latest weekly data. Novo Nordisk's Wegovy pill, which launched in January, commands the rest.
It is a remarkable turn of events for the near $80 billion anti-obesity market, among the hottest in the industry. Lilly dominates sales of shots. Analysts figured the company's pill would similarly crush it.
Among the challenges, doctors say, is study data indicating that people taking Novo Nordisk's pill lost an average of 16.6% of body weight after more than a year, versus 12.4% for Foundayo.
Also slowing Lilly was the time it took for the company to lock in reimbursement from health plans, according to analysts.
It took two months for CVS Caremark, one of the biggest prescription-drug-benefit administrators, to add Foundayo to its list of preferred drugs, for example. As of the start of June, Lilly's drug was covered by the three biggest pharmacy-benefit managers. These decisions should help sales but some health plans could still choose not to cover weight-loss drugs.
A Lilly spokesperson said "we expect momentum to build as physicians, pharmacies, and patients learn more about Foundayo."
Novo Nordisk says the efficacy of the Wegovy pill is driving its lead. "Wegovy pill is the better pill, from an efficacy standpoint," said Jamey Millar, executive vice president of U.S. operations at Novo Nordisk.
The race is in its early days. Now that it has secured broader health-plan coverage, Lilly has the potential to unlock more prescriptions. Many of its orders to date have been through a company website, for patients willing to pay at least $149 a month out of pocket.
Lilly is aiming to increase Foundayo prescriptions by getting the word out to doctors, an area where it already has inroads and a track record of progress.
The stakes are tremendous. Weight loss, long a graveyard for drug-company ambitions, has emerged as one of the industry's biggest and fastest-growing segments. Rivals including Pfizer and Amgen have clamored to capture a piece.
For Lilly and Novo Nordisk, anti-obesity pills are the next battleground for control of the market, an opportunity to capture people who didn't want to inject themselves with shots.
Wall Street has been closely watching how the launches of the pills are faring.
In the week ending July 3, Novo Nordisk's Wegovy pill generated about 153,050 U.S. prescriptions compared with 19,550 for Eli Lilly's Foundayo pill, according to Iqvia data cited in a JPMorgan research note.
Adjusting for its few months' head start this year, Novo Nordisk is still outpacing Lilly. Its Wegovy pill had around 105,000 prescriptions during its 13th week on sale, more than five times Foundayo's, according to Jefferies analysts who called Lilly's launch "muted."
Seeing this slow start, analysts have been cutting their sales expectations for Lilly's pill. Deutsche Bank slashed its forecast of full-year 2026 Foundayo sales to $1.3 billion from around $3 billion. Conversely, analysts surveyed by FactSet have more than doubled their forecasts of 2026 Wegovy pill sales to $2.2 billion.
Dr. Holly Lofton, an obesity-medicine specialist at NYU Langone Health in New York, said she has written far more prescriptions for the Wegovy pill than for Foundayo, primarily because of the larger reported weight loss.
"That's what really makes the patient decision," she said.
Patients are more familiar with Novo's pill, doctors say, because it has the same name and main ingredient as the Wegovy shot. Also, it doesn't have certain restrictions that Foundayo has on what other drugs it can be taken with. Patients taking the Wegovy pill must wait a half-hour before eating while those on Foundayo don't have to, but doctors say that hasn't been a major deterrent.
Lilly proved it could overcome an early Novo Nordisk advantage with the shots. And the Indianapolis drugmaker is just beginning to exercise its marketing muscle for Foundayo.
The first TV ad for the drug aired in June during the NBA playoffs. Lilly has said it takes time to build brand awareness.
"Nobody knew what Foundayo was" two months ago, Kenneth Custer, head of Lilly's cardiometabolic health unit, said at an investor conference in June. "We've been out really reaching the healthcare community driving awareness of this medicine. Reception's been very positive and now we start to turn some of the other levers."
Many analysts predict Lilly's pill will eventually outsell Novo Nordisk's globally because Foundayo is easier to manufacture at a large scale. JPMorgan analyst Chris Schott said sales should pick up next year as Lilly starts rolling the drug out in more than 40 international markets.
Even Novo Nordisk isn't calling the game over. "I've never seen a pharma company declare victory after four months," said Novo's Millar.
Write to Peter Loftus at Peter.Loftus@wsj.com
(END) Dow Jones Newswires
July 14, 2026 20:00 ET (00:00 GMT)
Copyright (c) 2026 Dow Jones & Company, Inc.
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