The global weight-loss drug market is undergoing a profound transformation, with volume-for-value pricing and consumerization trends reshaping the competitive landscape.

According to a December 8 Goldman Sachs report, recent pricing agreements between Eli Lilly and Novo-Nordisk A/S with the U.S. government serve as key catalysts for this shift. These deals will significantly reduce prices for critical GLP-1 drugs like Zepbound and Wegovy starting in 2026, with the most notable breakthrough being Medicare coverage for these medications.

Simultaneously, direct-to-consumer (DTC) sales channels, retail partnerships, and telemedicine platforms are collectively driving the "consumerization" wave in the weight-loss drug market, substantially lowering patient access barriers and stimulating demand growth.

Prompted by price reduction expectations and consumerization trends, Goldman Sachs has raised its 2030 global anti-obesity medication (AOM) market forecast to approximately $102 billion.

"Volume-for-Value": Pricing Agreements Unlock Three Major Channels The Goldman report identifies the GLP-1 drug pricing agreements between Eli Lilly/Novo-Nordisk A/S and the White House as market-shaping developments. These agreements aim to expand patient access through Medicare, Medicaid, and DTC cash-pay channels by lowering prices—effectively incorporating the drugs into insurance coverage.

Key agreement details effective from 2026 include:

Medicare: A pilot program starting April 1, 2026, will cover Zepbound and Wegovy for obesity at $245/month with a $50 patient copay cap. In exchange, diabetes drugs Mounjaro and Ozempic will also drop to $245/month (down from Goldman's previous $350 estimate), removing a critical growth constraint.

Medicaid: Pricing remains at $245/month, though coverage varies by state. Currently, 13 states fully cover GLP-1 weight-loss drugs.

DTC/Cash-Pay: More attractive pricing emerges, with Wegovy at $349 (excluding starter doses), Zepbound multi-dose pens starting at $299 (max $449), and the anticipated oral orforglipron launching at just $149 (max $399).

Consumerization Wave: DTC and Retail Become New Battlegrounds Beyond policy changes, the market's "consumerization" is becoming another powerful growth engine. Goldman highlights that increased public awareness, lower costs, upcoming oral medications, and new distribution ecosystems (DTC, retail, telemedicine) are collectively reducing patient barriers.

Key drivers include: - Lower prices reducing financial barriers - Oral medications (Eli Lilly's orforglipron and Novo-Nordisk A/S's oral semaglutide) expected in 2026, targeting cash-pay/DTC channels - Strong overseas cash-pay market potential, evidenced by recent India sales - Emerging distribution platforms like LillyDirect, Walmart/Eli Lilly and Costco/Novo-Nordisk A/S partnerships, and telemedicine services

Data shows tangible impact: Gallup reports U.S. adults using GLP-1 drugs for weight loss doubled from 5.8% to 12.4% year-over-year. DTC channels show particular momentum, with LillyDirect accounting for 28% of Zepbound prescriptions by Q3 2025. Since June 2025, nearly all Zepbound prescription growth came from cash-pay channels, underscoring DTC's strength.

Demand Surge: U.S. User Projections Revised Upward Price reductions directly translate to volume growth. Goldman now forecasts: - 64 million U.S. patients with AOM access by 2030 (vs. prior 50M estimate) - 15 million actual users (vs. 12M) New access primarily comes from: - Medicare (+8M to 18M) - DTC/Cash-Pay (+2M to 12M) - Medicaid (+1M to 6M) - Commercial insurance (+1M to 28M)

Market Forecast Revised: Potential $102B by 2030 Goldman's updated model projects global AOM market potential reaching $102B by 2030 (up from $95B), with scenarios ranging from $115B (optimistic) to $90B (pessimistic). The core thesis: price declines will be offset by volume growth, driving market expansion.

Oral Drug Race Heats Up: Eli Lilly Gains Edge Oral weight-loss drugs launching in 2026—particularly Eli Lilly's orforglipron—are seen as pivotal for cash-pay/DTC channels due to convenience and lower costs. With FDA priority review accelerating orforglipron's launch to Q2 2026, Goldman raised its 2026 sales forecast to $1.5B (from $1.1B) and 2030 obesity-only projection to $19B (from $14B).

Eli Lilly management views orforglipron as a "generational opportunity," with once-daily dosing, no dietary restrictions, and potential cardiovascular benefits targeting broader markets. Consequently, Goldman raised Eli Lilly's 12-month price target to $1,145 (from $951), maintaining a "Buy" rating.

For Novo-Nordisk A/S, obesity drug sales forecasts remain largely unchanged through FY2028, though the company stands to benefit from Medicare access and faster DTC growth of oral Wegovy.

Following its Metsera acquisition, Pfizer's injectable GLP-1 agonist MET-097i enters Goldman's model, projected to launch in 2028 with $4B peak unadjusted global sales by 2035.

Upcoming clinical catalysts through 2026—including Eli Lilly's Retatrutide Phase III data, Pfizer's MET-097i monthly dosing results, and Novo-Nordisk A/S's CagriSema vs. Tirzepatide head-to-head data—will provide critical competitive landscape insights.