The global battle against obesity is set to enter a new phase in 2026 with the introduction of pill versions of blockbuster GLP-1 drugs. While Novo Nordisk and Eli Lilly are both gearing up for oral launches, financial analysts believe Eli Lilly's commanding lead in the diabetes and obesity treatment market is unlikely to be challenged anytime soon.
The Oral GLP-1 Race Heats Up
In the coming year, patients seeking weight-loss solutions will have a new option: pills. Novo Nordisk is expected to be first to market with its recently approved Wegovy pill. It will be followed around mid-2026 by a pill from Eli Lilly, currently known as orforglipron, which is awaiting regulatory clearance. This shift from injectable to oral medication could improve accessibility and convenience for millions.
However, the race to the pharmacy shelf is just one part of the story. According to Guggenheim analyst Seamus Fernandez, Eli Lilly will continue to expand its substantial lead in the category, even with a later pill launch. The company's stock performance reflects this confidence, with shares up nearly 40% in 2025, driven by an estimated 60% growth in sales of its weight-loss and diabetes drugs. In contrast, Novo Nordisk's shares fell by a similar percentage, with its overall sales growth projected at only about 5%.
Market Share and Future Growth
Current prescription data underscores Lilly's dominance. In the diabetes market, Lilly's Mounjaro holds a 47% share compared to 38% for Novo's Ozempic. The gap is even wider in obesity treatment, where Lilly's Zepbound commands a 64% market share versus 36% for Novo's Wegovy.
Looking ahead, Fernandez projects Lilly's GLP-1 drug sales to grow at a compound annual rate of 16% over the next five years, vastly outpacing Novo's estimated 2% growth. This optimism is fueled not just by the upcoming pill but by Lilly's robust pipeline. The analyst notes that Lilly's injectable lineup will be supplemented by a powerful new drug called retatrutide and a complementary therapy, eloralintide, which may help preserve muscle mass during weight loss.
Challenges and Competitors on the Horizon
While pills promise easier administration and lower production costs, they come with drawbacks. Side effects like nausea may be more pronounced, and Novo's pill must be taken on an empty stomach. Some experts, like KeyBanc Capital Markets analyst Paul Knight, believe injectables will remain the preferred method for the fastest and most significant weight loss for years. He suggests oral versions might eventually serve as maintenance therapy.
Other players are also entering the field. Structure Therapeutics saw its shares more than double in December 2025 after reporting 15% weight loss in a Phase 2 trial of its pill, outperforming the 12% seen in Lilly's studies. However, with a pivotal Phase 3 trial potentially not starting until late 2026, Structure is not expected to be a major competitor for several years.
The narrative for 2026 is clear: the arrival of weight-loss pills marks a significant evolution in treatment. Yet, in the high-stakes pharmaceutical arena, Eli Lilly's strategic execution and deep product portfolio position it to maintain its leadership throne well beyond the pill's debut.
