Key Insights

Novo Nordisk sees significant opportunities outside the United States and notes that telehealth partners can aid the global expansion of weight-loss medications. The current battle for dominance in this high-margin market is primarily concentrated in the U.S., with both Novo Nordisk and Eli Lilly deriving over half of their sales from the American market. Analysts predict the United Kingdom, Germany, and Denmark are the most likely next countries for the launch of Wegovy tablets.

Wegovy (semaglutide) Tablets As competition in the weight-loss drug market goes global, Novo Nordisk has informed CNBC that it is preparing a full-scale push to launch Wegovy tablets in markets outside the United States. "We will go full throttle once we launch. It is a significant opportunity," said Emil Kongshøj Larsen, Executive Vice President for International Operations at Novo Nordisk, in a CNBC interview on Tuesday. Last week, Novo Nordisk announced that, following the blockbuster reception and unprecedented uptake of Wegovy tablets in the U.S., it expects to initiate its first launches outside America later this year, pending regulatory approvals. Currently, both Novo Nordisk and its main competitor, Eli Lilly, generate more than half of their sales from the U.S. market. However, as weight-loss drugs have reshaped the pharmaceutical industry in recent years, both companies are increasingly focusing on expanding their overseas presence. Larsen did not specify the initial launch countries, stating only that the company will deploy **"based on market potential,"** considering local patient demand for obesity treatment, physician expertise, and the availability of suitable telehealth partners. He highlighted telehealth as a crucial pathway to expanding patient access. Using Germany as an example, he noted, "Progress was slow for a period, but telehealth suddenly made treatment accessible and satisfactory for patients."

Novo Nordisk vs. Eli Lilly: A New Phase in Oral Drug Competition? Eli Lilly expects a 28% increase in sales growth at the midpoint of its guidance range for this year, whereas Novo Nordisk anticipates a notable decline in its sales. Although Novo Nordisk slightly raised its full-year guidance last week, the company still projects a 4%–12% decline in profit and sales for 2026, impacted by price reductions in the U.S. and competition from generic drugs in markets like India, Canada, Brazil, and China. Despite this, Novo Nordisk gained a first-mover advantage in the oral weight-loss drug segment by launching Wegovy tablets in the U.S. this January. The company reported last week that cumulative prescriptions have exceeded 2 million, with first-quarter sales significantly surpassing expectations despite price adjustments. "In an era of high connectivity through social media, digital platforms, and public discourse, we couldn't have asked for better pre-launch momentum," Larsen remarked on the U.S. launch performance, adding, "This has also been extremely positive for our injectable business; the entire Wegovy brand has been activated." Analysts at Nordea noted in a research report that, according to Google Trends data, Wegovy is becoming the most well-known weight-loss brand in the U.S., aligning with prescription trends. Meanwhile, Eli Lilly stated on April 30 that over 20,000 patients have started treatment with its competing oral drug, Foundayo, since its launch earlier this month. Analysts closely tracking weekly U.S. prescription data, citing IQVIA figures (which do not cover all prescriptions but reflect demand trends), report that Foundayo prescriptions during the same period are significantly lower than those for Wegovy tablets. Eli Lilly CEO David Ricks told CNBC last month that building Foundayo into a strong brand **"takes time."** The active ingredient in Foundayo differs from that in Lilly's blockbuster injectables Mounjaro and Zepbound, whereas Novo Nordisk's Wegovy tablets are essentially an oral extension of its injectable version. "Our ramp-up will be different because it's a new brand, a new molecule," Ricks said. "This will play out over quarters, not days... The market should be patient and watch us execute." Barclays analyst Emily Field pointed out last week that oral Wegovy and Foundayo target different patient groups: the former offers efficacy close to that of an injectable, while the latter is more akin to an entry-level GLP-1 drug. Both Ricks and Novo Nordisk CEO Mike Doustdar believe that the two oral drugs are expanding the overall weight-loss medication market rather than merely cannibalizing demand for injectables.

Global Launch Advancement The oral formulation holds significant appeal for patients. Larsen told CNBC, "We believe this trend will replicate outside the U.S." He expressed confidence that Wegovy tablets' significantly superior efficacy means the company need not worry about launching later than competitors in some markets. Research indicates that Wegovy tablets demonstrate more pronounced weight loss effects than Foundayo and offer certain cardiovascular benefits, although no direct head-to-head clinical trials comparing the two drugs currently exist. Novo Nordisk anticipates strong demand for Wegovy tablets in international markets, though the growth trajectory may not mirror that of the U.S. exactly. Larsen explained that the U.S. market is not directly comparable, as uptake depends on the relative price difference between oral and injectable formulations. "We are not disclosing pricing strategies at the moment, but we can say: In the U.S., the product is very strong, but its price positioning differs from injectable therapy." He predicts that the sales curve in international markets may be slightly flatter than in the U.S. Sydbank analyst Soren Hansen told CNBC on Wednesday that Wegovy's launch outside the U.S. will be more selective and dependent on the company's ability to match supply with demand. He views large European markets like the UK and Germany, as well as Novo Nordisk's home country, Denmark, as likely candidates for the initial launches. Larsen emphasized to CNBC that Novo Nordisk believes growth for obesity GLP-1 drugs will primarily come from self-paying patients rather than those covered by national health systems or commercial insurance. "Even in a universal healthcare system like Denmark's, 99% of patients pay out of pocket. We never imagined this when we started in obesity treatment a few years ago."

Significant International Market Potential Eli Lilly CEO David Ricks told CNBC in late April that the global market offers substantial growth space for the company. "There are 1 billion people globally who could potentially benefit from these drugs... Currently, we are reaching about 20 million." Eli Lilly's first-quarter revenue outside the U.S. surged 81% year-over-year to $7.7 billion, with volume growth of 95%. U.S. revenue grew 43% to $12.1 billion. Ricks stated, "It turns out people all over the world want to lose weight." The so-called **"Most Favored Nation"** pricing policy from the previous U.S. administration—which ties U.S. drug prices to several reference countries—has complicated overseas launches for several pharmaceutical companies. Novo Nordisk's Larsen stated that European national drug pricing policies would not affect the launch pace for self-pay markets in Europe. "European governments must recognize that paying for high-quality innovation that can change public health is crucial. Otherwise, R&D investment and clinical trials will continue shifting to the U.S. or China—as we are already seeing."