The competition in the closely watched oral weight-loss medication market sees Eli Lilly currently trailing behind its rival Novo-Nordisk A/S. Since its launch in April, Lilly's drug Foundayo has captured approximately 11% of new oral weight-loss prescriptions, while the oral version of Novo Nordisk's Wegovy, launched in January, has taken the vast majority of the remaining share. This market dynamic has surprised observers, as Lilly previously held a dominant position in the injectable weight-loss market, and its oral drug was widely expected to perform strongly as well.

Key Factors Behind the Lead

Analysts point to the superior weight loss efficacy demonstrated in clinical trials as a key factor for Novo Nordisk's lead. Research data shows that patients taking the oral Wegovy achieved an average weight loss of 16.6% over a year-long treatment period, compared to 12.4% for Foundayo. Dr. Holly Lofton, an obesity medicine expert at NYU Langone Health, stated that the magnitude of weight loss is a primary deciding factor for patients when choosing a medication.

Initial Hurdles for Lilly

Furthermore, the pace of securing insurance coverage negotiations has hampered Lilly's initial performance. Major pharmacy benefit managers like CVS Caremark only added Foundayo to their preferred drug lists two months after its launch, with the three largest national PBMs completing coverage by early June. Lilly has indicated that sales momentum is expected to gradually build as doctors, pharmacies, and patients become more familiar with the product.

Market Data and Analyst Expectations

Data from Iqvia cited by JPMorgan shows that for the week ending July 3rd, U.S. prescriptions for oral Wegovy were around 153,000, compared to approximately 19,600 for Foundayo. Analysts at Jefferies noted that even accounting for the difference in launch timing, Novo Nordisk remains significantly ahead, with prescriptions around 105,000 in its 13th week—over five times Foundayo's volume at the same stage. Deutsche Bank has revised down its full-year 2026 sales forecast for Lilly's oral drug to about $1.3 billion from approximately $3 billion, while FactSet analysts have more than doubled their sales expectation for oral Wegovy over the same period to $2.2 billion.

Physician and Patient Perspectives

Doctors note that patients are more familiar with Novo Nordisk's oral drug because it shares the same name and primary ingredient as the injectable Wegovy and does not carry some of the usage restrictions associated with Foundayo. Although taking oral Wegovy requires fasting for 30 minutes before a meal—a requirement not needed for Foundayo—doctors do not consider this a major barrier.

Lilly's Strategy and Long-Term Outlook

Lilly emphasizes its active efforts to promote Foundayo to the medical community, including airing its first television advertisement during the NBA playoffs in June. Kenneth Cast, head of Lilly's cardiometabolic health division, stated that building brand awareness takes time and that feedback from healthcare professionals has been very positive. JPMorgan analysts anticipate sales could accelerate next year as Lilly launches the drug in over 40 international markets. Most analysts believe that, in the long term, Lilly's oral drug has the potential to surpass Novo Nordisk's globally due to its greater advantages in large-scale manufacturing. Doug Langa, executive vice president of North America operations for Novo Nordisk, also remarked that he has never seen a pharmaceutical company declare victory just four months post-launch, indicating that the market competition is far from over.