Eli Lilly Dominates U.S. Obesity Market Share

Eli Lilly held a commanding 60.9% share of the U.S. obesity and diabetes drug market in the second quarter, according to CNBC‘s earnings presentation. In comparison, rival Novo Nordisk held a 38.8% share during the same period. The performance underscores a widening divide in Wall Street’s confidence between the two obesity drug leaders, even as both companies beat second-quarter estimates and raised their full-year outlooks.

Eli Lilly Dominates U.S. Obesity and Diabetes Market Share

Lilly reported another quarter of blistering growth, driven by resilient demand for its blockbuster diabetes treatment Mounjaro and its obesity drug Zepbound, which pushed revenue up 48% from a year ago. The company hiked its full-year revenue guidance, reinforcing investor confidence that its treatments can sustain sales momentum despite lower U.S. prices. Analysts at Bernstein noted in a research note that Lilly remains best positioned to capture the majority of global incretin market growth, a space encompassing obesity and diabetes treatments.

Oral Treatment Competition and Prescription Momentum

The rivalry between the two drugmakers extends into the developing oral obesity treatment market, where Novo Nordisk’s oral Wegovy pill maintains a substantial volume lead while Eli Lilly’s rival oral treatment, Foundayo, shows stronger prescription momentum. Weekly Foundayo prescriptions increased 16% sequentially to 34,219, marking four consecutive weeks of growth, according to HLTH data citing Citi and IQVIA figures. Those numbers followed weekly totals of 29,388 and 26,760 in preceding periods, though IQVIA figures may not fully capture prescriptions originating through telehealth channels.

Eli Lilly Dominates U.S. Obesity Market Share — Photo: HLTH

Lilly’s oral treatment rollout followed second-quarter performance figures where Foundayo generated $98 million in total sales, including $67 million in the U.S., which came in below expectations from several analysts. Lilly subsequently initiated broader direct-to-consumer marketing after securing commercial access across the three major pharmacy benefit managers in June and additional access through the Medicare GLP-1 Bridge program on July 1. Ilya Yuffa, president of Lilly USA and global customer capabilities, stated that the company is starting to see an inflection point on Foundayo.

Meanwhile, Reuters notes that Novo’s oral Wegovy pill remains considerably ahead by prescription volume, recording approximately 172,000 weekly prescriptions with volumes remaining largely flat aside from modest increases in previous weeks. Oral Wegovy now accounts for about 35% of total Wegovy prescriptions. Across both oral and injectable formulations, Wegovy accounts for approximately 40.6% of the U.S. obesity market.

Broader Pipeline Challenges and Market Stakes

The intensifying competition unfolds against the backdrop of a global market that analysts expect to be worth more than $100 billion by the 2030s, or by the end of the decade in the United States alone. While Novo Nordisk topped Wall Street expectations and lifted its full-year outlook, citing increased expectations for GLP-1 product sales and temporary factors such as rebate adjustments, the company faces scrutiny over its broader pipeline and long-term growth prospects.

An illustration photo shows boxes of Wegovy (semaglutide) tablets in this illustration picture taken in Schwenksville — Photo: Reuters

Novo reported mixed trial results on its key experimental obesity drug, CagriSema, which failed to deliver as much blood sugar control as Zepbound in a large trial. That marked the second time in the year that the new drug failed to match Lilly’s weight loss treatment, following a late-stage heart drug trial failure that failed to reduce major cardiovascular events compared to a placebo. BMO Capital Markets analyst Evan Seigerman noted that while Novo raised guidance, the pipeline and path to sustainable growth remain less clear.