Novo Nordisk says Wegovy pill outperforms Lilly’s oral GLP-1 in cross-trial comparison


Wegovy semaglutide tablets.

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The Wegovy pill showed more pronounced weight loss and less cumbersome side effects than Eli Lilly‘s rival pill that was approved this week, Novo Nordisk said Thursday. 

Oral Wegovy demonstrated “significantly greater mean weight loss” than orforglipron, which Lilly will sell under the brand name Foundayo from next week, in an indirect study that compared the outcomes of other studies.

Novo’s findings evaluated previously published studies of the medicines and did not include any fresh data points. It will present further details of the study at the Obesity Medicine Association’s annual conference next week, the Danish drugmaker said.

A separate analysis suggested that 84% of patients favored a drug profile similar to that of semaglutide, the active ingredient in Wegovy and Ozempic, to that of Foundayo, Novo said. 

“These studies add to the growing body of evidence supporting the clinical strength of semaglutide and highlight attributes that patients value when choosing an obesity medicine that fits their lifestyle,” said newly-appointed Jamey Millar, executive vice president for U.S. operations. 

Efficacy versus ease

It comes as Novo and Lilly are both trying to shape the narrative of their respective pills, which is broadly considered to be the start of the next phase of the weight-loss drug era. The introduction of pills as an alternative to injections is expected to scale the market, as they are more easily distributed worldwide and favored by consumers. 

Eli Lilly CEO Dave Ricks told CNBC this week that Foundayo is more accessible and can more easily be fitted into daily routines. 

Foundayo can be taken without food restrictions, while the Wegovy pill needs to be taken first thing in the morning on an empty stomach with only a small amount of water, and patients must wait at least 30 minutes before eating. 

Novo Nordisk says Wegovy pill outperforms Lilly’s oral GLP-1 in cross-trial comparison

Novo CEO Mike Doustdar pushed back on the notion that those restrictions would limit uptake, telling CNBC in March that it was “absolutely not the case.”

“People are really interested because it’s the most efficacious pill right now in the market,” Doustdar added.

Earlier studies have shown that oral Wegovy results in an average of 16.6% weight loss, while Foundayo showed 12.4% on average among patients who stayed on the treatment. 

Since launching the Wegovy pill in the U.S. in early January, prescriptions have skyrocketed, and over 600,000 patients have since begun taking the pill. Analysts have described it as one of the best launches of a new medicine ever, with initial uptake quicker than injectable versions. 

However, following a strong launch, the number of patients being prescribed the starter dose seems to be flattening, Barclays analyst James Gordon said on Wednesday. 

“Slowing new starts, we believe could be the result of patient warehousing as physicians await LLY’s Foundayo (orforglipron) launch,” Gordon wrote in a note to clients.

Several analysts said that the trajectory of Foundayo’s prescriptions will be a key share price determinant over the next weeks and months. 

Expectations for 2026 Foundayo sales have come down meaningfully over the past month, from about $4 billion to $1.6 billion, said RBC Capital Markets analyst Trung Huynh on Wednesday. 

“Although there have been headwinds on pricing erosion in the GLP1 space, we believe there is substantial upside with the expected Medicare Part D expansion later this year,” noted Huynh. 

An RBC survey of nearly 200 patients, prescribers and payers in March indicated that Foundayo would be a preferred oral option amongst patients since it has no dosing restrictions.

The differentiation factor

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Lilly shares have outperformed Novo’s American depositary receipts over the past year.

The market for obesity drugs might not be as large as previously expected, HSBC cautioned last month, as it recommended clients sell Lilly stock which has significantly outperformed Novo over the past 18 months. 

Expectations for Foundayo sales are overblown and likely to disappoint, the broker said.

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These 4 charts show the scale of Novo Nordisk’s woes


Novo Nordisk was the first company to make a GLP-1 drug for weight loss and became Europe’s most valuable company.

But its troubles are stacking up and today the stock trades at just a quarter of what it did at its peak less than two years ago.

Pricing pressure, fierce competition, and pipeline setbacks have all hit the Danish drugmaker in recent months.

Despite being first to launch a GLP-1 drug for weight loss, Novo’s market share has eroded, and the company now only captures about 40% of the market, while rival Eli Lilly holds 60%, according to most estimates.

Novo is clear-eyed about the challenges it faces, especially around pricing. After the company pre-released its 2026 forecast earlier this month and predicted declining sales, CEO Mike Doustdar told CNBC: “People should expect that it goes down before it comes back up.”

He’s repeatedly said that new medicines, the Wegovy pill, and increased volumes will drive long-term growth.

These charts show the scale of the challenges Novo is facing.

Novo Nordisk is often referred to as a diabetes and obesity pure play. Its portfolio included six branded drugs with annual sales of at least $1 billion in 2025, fewer than comparable current and future rivals.

Eli Lilly boasts eight so-called blockbuster drugs, and its portfolio also includes oncology and gene therapies.

The combined sales of Ozempic and Wegovy, Novo’s two biggest drugs, amounted to about $32 billion, or about 67% of total sales, last year. Combined sales of Lilly’s two biggest drugs, Mounjaro and Zepbound, were about $37 billion, or about 56% of the company’s total sales over the same period.

Novo also sells insulin, including blockbusters Tresiba and NovoRapid, as well as some drugs for rare diseases like hemophilia, but none come close to bringing in what its GLP-1 drugs do.

Among large-cap pharma companies hoping to enter the market for weight loss drugs in the coming years, such as AstraZeneca, Roche, Amgen, and Pfizer, through its acquisition of Metsera, the number of blockbuster drugs was significantly higher.

Novo Nordisk has also come under pressure as prices for GLP-1 drugs are coming down in its most important market, the U.S.

The U.S. has accounted for more than half of Novo’s total sales since 2023, and falling prices there are weighing on both the company’s topline and profitability. Last year, Novo and Lilly reached a deal with the Trump administration to lower prices on their GLP-1 drugs on Medicare and Medicaid and offer the treatments directly to consumers at a discount.

“In 2026, Novo Nordisk will face pricing headwinds in an increasingly competitive market,” said CEO Mike Doustdar, as the company’s full-year earnings report was published earlier this month.

Novo stock is down 75% since peaking at just over 1,000 Danish kroner a share in mid-2024.

The stock is up a little over 10% over the last five years. That compares to Eli Lilly’s 400% rise and the European blue-chip index Stoxx 600‘s 55% gain over the same period.

Investors were last rattled on Monday when Novo reported disappointing results of a trial pitting its next-generation weight loss drug, CagriSema, against Eli Lilly’s tirzepatide, also known as Zepbound, sending the stock down over 16% on the day.

“Confidence in the share is at rock bottom,” said Jyske Bank analyst Henrik Hallengreen Laustsen on Tuesday.

Earlier this month, Novo Nordisk said it expected sales and profits to drop by between 5% and 13% in 2026. If that comes to be true, it would be the first time annual sales have declined since 2017, in local currencies.

Analysts surveyed by FactSet expect sales to come in about 8% lower in 2026 compared to 2025. Much of that is due to increasing competition from both Eli Lilly and compounding pharmacies that are selling copycat versions of Novo’s branded drugs for a lower price.

Longer term, other large-cap pharma companies are planning to enter the market, and are pitching investors more differentiated weight loss drugs to be able to secure a slice of the market share for themselves.

Novo is hoping CagriSema can beef up future sales, but after the latest trial results, analysts are increasingly doubting its commercial potential.

Novo said it is optimistic about the drug, and that further trials would assess its full weight-loss potential.

The Wegovy pill is another potential growth driver for Novo and had a strong launch. However, it remains to be seen how it will fare if Lilly launches its rival pill, expected to hit the market in the second quarter, and what effects lower prices might have on volumes.