The weight-loss drug market has entered a new competitive phase, though not necessarily a price war. This November, the pharmaceutical industry witnessed a series of dramatic twists involving three major players in the weight-loss drug sector.

On November 13, Pfizer announced its acquisition of Metsera, a weight-loss drug developer, for over $9 billion, thwarting Novo Nordisk's last-minute bid. Metsera had initially agreed to a deal with Pfizer, but Novo Nordisk attempted a high-priced takeover on October 30, leading to legal disputes. After multiple price hikes, Pfizer secured Metsera for $9.2 billion, while Novo Nordisk withdrew.

Earlier, on November 6, former U.S. President Donald Trump announced a price cut for weight-loss drugs to $245 per month—a reduction of at least 65%. Remarkably, despite these developments, shares of all three companies rose.

In 2025, Eli Lilly and Novo Nordisk emerged as the biggest winners in the global GLP-1 weight-loss drug market. Eli Lilly's stock surged the most, hitting record highs for several consecutive days, with its market capitalization nearing $1 trillion. Novo Nordisk and Pfizer saw gains of 5%–9%.

While some Chinese investors anticipate a low-price competition era for GLP-1 drugs by 2026, the U.S. price cuts have not dampened investor enthusiasm. What factors are driving this trend?

**Impact of U.S. Drug Price Negotiations** The U.S. government's bargaining power rivals that of China's centralized drug procurement system. Under Trump's proposal, the monthly cost of GLP-1 injections will drop to $350 (about ¥2,500), eventually reaching $245 (¥1,750). An oral version, pending U.S. approval, may cost as low as $149 (¥1,060). Currently, U.S. patients pay over $1,000 monthly for these drugs, implying a 65%–75% price reduction.

In China, Eli Lilly's GLP-1 drug tirzepatide is priced at ¥1,200–3,000, slightly higher than the post-cut U.S. price. Novo Nordisk's semaglutide injection costs ¥750–1,750 monthly, aligning with its projected U.S. price in two years.

Eli Lilly confirmed its highest-dose tirzepatide would cost $449 monthly (about ¥3,200), matching its Chinese price. This stems from Trump's "most-favored-nation" policy, linking U.S. drug prices to the lowest global rates. Since his re-election in January 2025, Trump has pushed this initiative, securing agreements with Pfizer and AstraZeneca for tariff exemptions in exchange for price cuts.

Novo Nordisk and Eli Lilly also secured three-year tariff exemptions, citing improved drug accessibility. Eli Lilly stated the deal would expand coverage, enabling earlier treatment for obese patients. With 100 million obese U.S. adults, fewer than 5% currently qualify for medication.

U.S. Health Secretary Xavier Becerra noted that TrumpRx, a new platform, would offer GLP-1 drugs at the lowest price, even for those outside Medicaid or Medicare. Medicare beneficiaries may pay just $50 (¥356) monthly after insurance, potentially covering 6.6 million users.

Analysts estimate tirzepatide, the top-prescribed U.S. weight-loss drug, serves 2.7 million users. If oral drugs drop to $149/month, Eli Lilly alone could gain 15 million new users—a key reason for the stock surge.

Eli Lilly's shares surpassed $1,000 on November 13, with a market cap of $969.3 billion by the next day. Novo Nordisk, recovering from a 2024 slump, rose 5% despite warning of single-digit revenue declines in 2026 due to price cuts.

An analyst noted that U.S. drug pricing reforms, unlike China's centralized procurement, may face slower implementation, leaving future prescription volumes and supply uncertain.

**Big Pharma's Strategic Bets** No current GLP-1 drug is "perfect." Industry experts suggest newer drugs with fewer side effects and better convenience could replace discounted ones. Eli Lilly emphasized its three-year tariff exemption and freedom from future price caps, allowing non-discounted drugs to maintain higher prices.

Novo Nordisk's pursuit of Metsera amid price negotiations reflects this strategy: "When old drugs face price cuts, new drugs become critical." The company aims to build a diversified "beyond weight-loss" portfolio targeting metabolic, cardiovascular, and functional health.

Eli Lilly plans to invest over $50 billion in R&D by 2030 to accelerate next-gen drugs. Novo Nordisk is aggressively acquiring multi-mechanism GLP-1, oral, and long-acting candidates, calling obesity treatment a "core strategic area."

Metsera's MET-097i, a novel GLP-1 drug with potentially higher efficacy and fewer side effects, drew Novo Nordisk's 23% premium bid. Eli Lilly and Roche are developing similar drugs. An analyst praised Novo Nordisk's endocrine expertise, citing its insulin dominance as proof of its clinical and market prowess.

Oral GLP-1 drugs, easier to use than injections, are a major R&D focus. Novo Nordisk's oral semaglutide, approved for type 2 diabetes, requires fasting and has absorption limitations. Eli Lilly's oral orforglipron, slated for 2026, offers flexible dosing and superior efficacy.

Pfizer, despite past oral drug failures, doubled down by acquiring Metsera for $9.2 billion. CEO Albert Bourla called obesity "one of the fastest-growing therapeutic areas." Metsera's MET-097i and amylin analog, both with monthly dosing potential, could revolutionize treatment.

Monthly dosing is a key trend. Novo Nordisk's weekly semaglutide boosted the market by improving compliance. Similarly, Amgen's monthly PCSK9 inhibitor outperformed biweekly rivals in sales.

Novo Nordisk abandoned a monthly GLP-1 project, while Amgen advanced to Phase III trials in March 2025. No monthly weight-loss drug has yet reached the market, leaving the field open for innovation.

In chronic disease markets, patient experience—like fewer doses—can drive adoption, as noted by a pharma executive.