Is Novo or Lilly winning the GLP1 war? For pills?

Claude analysis below the story. Bottom line: Lilly is likely to catch up and surpass Novo in the pill wars for GLP1s. Competition is coming however from other players which should continue to push down the cost for users wanting to lose weight.

FOOD FIGHT

By Snacks Media

Aug 10, 2026

Lilly may be winning the war, but Novo is winning the pill battle

Is Novo Nordisk’s losing streak coming to an end?

Novo is getting a boost from its Wegovy pill, which has been flying off the pharmacy shelves since it came to market in January. In the first quarter of this year, sales for the drug were nearly twice what Wall Street was penciling in.

It’s been the biggest GLP-1 debut by volume ever. According to Novo, the pill has now reached over 5 million total prescriptions and it's only accelerating: it took 12 weeks to reach its first 1 million patients, but its latest 1 million were added in just a month. A big chunk of that has been through its direct-to-consumer platform.

“We are more and more ourselves getting surprised [by] how many people are after a pill rather than an injection, frankly,” CEO Mike Doustdar told analysts on August 5.

It’s a bright spot in an otherwise gloomy picture for the Danish pharmaceutical company. Novo has increasingly lost ground to its rival, Eli Lilly, in the lucrative injectable weight loss and diabetes drug market, which still accounts for the vast majority of GLP-1 prescriptions.

Eli Lilly — despite having the best-selling drug in the world, Mounjaro and Zepbound — has had an underwhelming debut for its weight loss pill, Foundayo. The drug, which came to market in April, brought in $98 million in revenue in the second quarter, less than the $103 million the Street was expecting.

While its pill may not be a blockbuster (yet, at least), the company’s next-generation injectable drug, retatrutide, has had impressive results in clinical trials. So impressive many people aren’t even waiting for FDA approval to start taking it.

It’s worth noting that all signs suggest the introduction of oral GLP-1 options has expanded the population of patients on these drugs, meaning they likely aren’t taking away sales from injectables already on the market.

THE TAKEAWAY

While Novo was early to the GLP-1 market with Ozempic, it has spent the past year or so living under Lilly’s shadow. The Wegovy pill has certainly changed the vibe for Novo.

Brian Mulberry, chief market strategist at Zacks Investment Management, which holds both Lilly and Novo, said the biggest question is if Novo will be able to get the pill to as many patients who want it. The company has had issues with manufacturing capacity in the past.

“That all comes down to execution though, and Novo has seen headwinds in ramping up scale to compete with their larger peers,” Mulberry said.

— J. Edward Moreno

Claude: Where things are right now (as of early August 2026):

Novo's first-mover advantage in pills is real but starting to look fragile. Oral Wegovy launched in January and posted first-quarter sales of about $354 million, then grew to $497 million in Q2 — up 42.6% quarter over quarter, but slightly below analyst expectations. Foundayo (Lilly's orforglipron), by contrast, launched three months later and posted only $98 million in its first quarter available, versus Novo's $355 million in its own first quarter. On the surface, that looks like Novo's pill lead is holding. BioPharma Dive + 2

But the details cut the other way. Foundayo's slow start is largely explained by a completely new drug class needing physician and patient education, whereas Novo simply repackaged an already-familiar molecule (semaglutide) into pill form, plus a PBM coverage lag — CVS, the last of the big three PBMs, didn't cover Foundayo until June 1, while Wegovy had full coverage at launch. Once that catches up, momentum has already turned: Foundayo prescriptions jumped 16% week-over-week in the most recent data, marking four straight weeks of growth. BioSpace + 2

Why I'd expect this to replay the injectable pattern:

This is essentially a rerun of Zepbound vs. Wegovy in injectable form — Lilly launched later, slower, and then took the lead on superior efficacy and manufacturing scale (Zepbound's superior efficacy pushed it past Wegovy to roughly 60% market share, with sales up 123% year-over-year vs. Wegovy's 17% growth). Orforglipron has two structural advantages that should compound over a 36-month window: emarketer

• It's a true small molecule, not a peptide — simpler and cheaper to manufacture, which likely means lower prices over time and none of the cold-chain/capacity constraints that have throttled peptide-based drugs. That matters enormously for scaling into global and cash-pay markets. Heally

• No fasting requirement — Foundayo is the first oral GLP-1 with no food or water restrictions, unlike Wegovy's pill, which must be taken 30 minutes before eating with only plain water. That's a meaningful real-world adherence edge once awareness catches up. Heally

Meanwhile Novo's broader pipeline stumbled this quarter: its CagriSema combination drug failed to control blood sugar as well as Lilly's tirzepatide in a head-to-head diabetes trial, compounding an earlier miss where CagriSema failed to match up to Zepbound in a February obesity study. Novo doesn't have an obvious next-gen answer queued up the way Lilly does with retatrutide and orforglipron's expanding label (sleep apnea, knee osteoarthritis, hypertension trials are already underway). BioPharma DiveBioPharma Dive

My expectation for the next 36 months:

1. Novo likely keeps the oral lead through 2026 on pure volume, given its head start and stronger initial efficacy data, but Foundayo's growth curve should keep steepening as PBM coverage completes and awareness builds — plausibly crossing Wegovy pill sales sometime in 2027.

2. By 2028, I'd expect orforglipron's manufacturing-cost advantage to let Lilly undercut on price and push harder into ex-US and cash-pay markets, similar to how Zepbound scaled past Wegovy.

3. The bigger risk to both incumbents isn't each other — it's the next wave (retatrutide, amycretin, and oral entrants from Pfizer, AstraZeneca, and Regor) potentially reshuffling the whole board again before this 36-month window closes.

The honest caveat: pharma launch trajectories are genuinely hard to call this early — Foundayo could underperform if the "no fasting" edge doesn't move prescribing behavior the way Lilly hopes, and Novo could stabilize with better global rollout. But if you're looking at this from an investment-allocation lens given your buy-and-hold approach, the pattern so far looks more like "Lilly repeats its injectable playbook with a lag" than "Novo holds its pill lead."