Eli Lilly’s GLP-1 development is just getting began as Novo Nordisk braces for a decline in 2026 – Company Technique & Outlook

It is a story of two drugmakers within the red-hot weight problems drug market. 

Each Novo Nordisk and Eli Lilly are grappling with decrease costs within the U.S., however their 2026 outlooks are diverging sharply: Whereas Novo is bracing for a gross sales decline, Lilly sees income leaping once more because of its blockbuster medicines. 

The cut up in steerage — regardless of comparable headwinds — underscores the power of Lilly’s place within the weight problems and diabetes drug market, underpinned by its simpler injections and early foray into direct-to-consumer gross sales, amongst different elements. Whereas Novo Nordisk successfully made the medication mainstream, Lilly has since taken a transparent edge in market share — and the forecasts present it’s going to seemingly solely lengthen its benefit this 12 months.

“The distinction in gross sales momentum and market share development was seen all through 2025, however the dichotomy between the 2 corporations’ prospects was accentuated inside this 24-hour interval by which Novo guided under consensus and Lilly guided above consensus expectations,”  Leerink Companions analyst David Risinger informed CNBC on Wednesday. 

“That basically solidified an investor’s thoughts that Lilly goes to be the dominant participant in weight problems going ahead,” he added. 

This 12 months, all eyes will probably be on how Lilly’s upcoming weight problems capsule, orforglipron, fares towards Novo’s personal oral Wegovy drug, which has had an explosive U.S. launch this 12 months.

In an interview on CNBC’s “Squawk Field” on Wednesday, Lilly CEO David Ricks mentioned 20 million to 25 million sufferers are presently taking each corporations’ medicines. However he mentioned the entire addressable market of sufferers within the weight problems house is “gigantic.” 

On Wednesday, Lilly forecasted 2026 gross sales of $80 billion to $83 billion, surpassing the $77.62 billion that analysts have been anticipating, in accordance with LSEG. 

The midpoint of that outlook interprets to gross sales rising by 25% this 12 months.

In distinction, Novo warned on Tuesday that it sees gross sales and revenue declining by 5% to 13% this 12 months, as costs fall within the U.S. and exclusivity expires for its blockbuster weight problems and diabetes medication in China, Brazil and Canada. 

Lilly equally pointed to a “world pricing decline within the low- to mid- teenagers [percentages] this 12 months.” That comes after the landmark “most favored nation” offers each corporations struck with President Donald Trump in November to slash weight problems and diabetes drug prices, together with their latest efforts to additional cut back direct-to-consumer costs for his or her remedies. 

The agreements with Trump are anticipated to take a chunk out of each corporations’ gross sales, however finally enhance volumes of prescriptions for his or her medication. Nonetheless, Lilly is bullish about different elements that may assist offset that pricing stress. 

That features continued worldwide demand for its weight problems drug Zepbound and diabetes counterpart Mounjaro and the anticipated launch of its GLP-1 capsule for weight problems within the second quarter, pending U.S. approval. Lilly additionally pointed to authorities Medicare protection of weight problems remedies beginning for the primary time by not less than July, one of many profitable options of the drug pricing offers with Trump. 

Lilly’s Ricks informed CNBC that protection will open up entry to 40 million new Medicare beneficiaries, “and that may very well be fairly expansive to quantity.”

Total, Risinger referred to as Lilly’s steerage “very encouraging” and mentioned the “value per quantity trade-off is taking part in out properly” for the corporate.

He mentioned tirzepatide, the lively ingredient in Zepbound and Mounjaro, is “superior” in its effectiveness and tolerability in comparison with semaglutide, the ingredient in Novo’s weight problems and diabetes medication. That was confirmed in a head-to-head scientific trial performed by Lilly in 2024, and prescription traits present that the corporate’s medication are most popular amongst prescribers.  

“I believe that is what is driving Lilly’s market share achieve” relative to Novo, Risinger mentioned. 

One other issue that units Lilly and Novo aside is patent exclusivity. Whereas Novo mentioned expiring patents in some worldwide markets pose a problem, Lilly’s Ricks mentioned tirzepatide ought to be protected into “the again half of the 2030s” in main markets. 

Risinger famous that Lilly continues to be working to drive world uptake for tirzepatide, which received U.S. approval for weight problems in 2023. 

Novo Nordisk is first to market with a GLP-1 capsule for weight problems, and it hit 50,000 weekly prescriptions in just below three weeks of its launch. However traders are watching to see how that shifts as soon as Lilly’s capsule rolls out to sufferers later this 12 months. 

In an interview with CNBC’s “Mad Cash,” Novo CEO Mike Doustdar mentioned he is assured concerning the firm’s capability to compete with Lilly. 

“Clearly now we have essentially the most efficacious weight-reduction capsule that there’s and I am very optimistic and bullish on once they include their capsule and now we have to battle this out,” Doustdar mentioned. 

He is referring to scientific trial knowledge suggesting that Novo’s Wegovy capsule promotes comparable weight reduction to its injectable counterpart, which is round 15%. In the meantime, Lilly’s capsule seems to be barely much less efficient than that, based mostly on separate examine knowledge. 

Risinger mentioned the launch of Novo’s capsule has benefited from the truth that the corporate is leveraging the Wegovy model identify, which is recognizable by many sufferers, and instantly launched direct-to-consumer promoting for the product in early January. 

However he mentioned Lilly may capitalize on its capsule’s comfort benefit. 

Orforglipron is a small-molecule drug that’s absorbed extra simply within the physique and does not require dietary restrictions like Novo Nordisk’s capsule, which is a peptide treatment. Sufferers are presupposed to drink not more than 4 ounces of water with the Wegovy capsule and should wait half-hour earlier than consuming or consuming the rest every day. 

Novo contends that these necessities will not hinder uptake, however Risinger mentioned it may assist Lilly’s capsule finally generate larger gross sales globally.