Novo Nordisk could unseat Eli Lilly as weight-loss drug leader in 2026

Novo Nordisk has gained U.S. approval for an oral version of Wegovy and is positioning the pill as a lower-cost, easier-to-use option. Eli Lilly’s oral candidate, orforglipron, completed phase 3 trials and has an accelerated FDA review that could lead to a decision soon.

Novo Nordisk recently won U.S. approval for an oral form of Wegovy and is promoting the treatment as a way to reach more patients. Wegovy’s brand previously helped make Novo Nordisk a major name in weight-loss drugs. Eli Lilly has taken a lead in market share with Zepbound, and it is pursuing an oral candidate, orforglipron, that showed strong phase 3 results. The FDA has granted orforglipron a voucher for an accelerated review timeline. Reported details: - Oral Wegovy received U.S. approval and is expected to have out-of-pocket costs in the range of about $149 to $299 per month for patients without full coverage. - Zepbound, marketed by Eli Lilly, has list prices reported up to $1,000 per month, though many patients pay less than list price. - Eli Lilly’s orforglipron succeeded in phase 3 studies across obesity and weight management and earned an FDA voucher that shortens its review to about one to two months. - An application for orforglipron was submitted late last year and the company could receive a regulatory decision soon, barring data or review issues. - Novo Nordisk has also pursued recent label expansions and is advancing next-generation candidates, including CagriSema, in mid- and late-stage development. Summary: The approval of an oral Wegovy may broaden Novo Nordisk’s reach by offering a lower-cost, pill-based option, while Eli Lilly’s orforglipron could arrive quickly under an accelerated review. How market share shifts will depend on pricing, patient preferences for pills versus injections, manufacturing reach, and the timing of each company’s commercial launches. Regulatory and commercial developments are likely to unfold in the coming weeks.