Novo Nordisk Wegoby Pills Defeat Eli Lilly Foundayo Early

When the Wegovy pill was launched in January, telemedicine provider LifeMD announced that its business doubled almost overnight.

LifeMD has gone from seeing 300 to 400 new patients per day to seeing 600 to 1,000 new patients per day, CEO Justin Shriver said. Although he knew there was a demand for it, he was surprised by the level of interest.

“There’s no question that the launch of oral medications has improved access,” Schreiber said.

Tens of thousands of people have started taking Novo Nordisk’s Wigovy pill in the four months since it went on sale in the U.S., the vast majority of whom are new to the GLP-1 category. Investors will get another look at the Wegovy pill’s momentum when Novo releases first-quarter results on Wednesday.

The launch is already forcing investors to rethink the oral GLP-1 opportunity and which companies will win it. Obesity and diabetes market leader Eli Lilly launched its pill Foundayo last month, but early signs suggest its rollout will be more modest than the launch of its Wegovy pill.

“As Lilly was talking, we were all in the Foundayo, Foundayo, Foundayo camp. We were also concerned about whether Novo would be able to produce enough peptide because it’s still coming out of the shortage,” said Evan David Sagerman, an analyst at BMO Capital Markets.

Now, Novo’s early success has upset the expectations of some investors and analysts who had expected the Danish company to lag behind its U.S. rival in oral as well as injectable drugs.

Novo’s Wigovy tablets use the same main ingredients as the weekly shot. The company sometimes struggled to produce enough peptides to meet the booming demand for injectables, and oral formulations required even more peptides. Meanwhile, Lilly told investors that its GLP-1 tablets are easy to manufacture and will not face any shortages that will hinder its development.

Questions about Lilly’s market lock arose last summer when the company announced that its pills helped people lose about 12% of their body weight on average. Zeigerman realized that Novo jumped at the opportunity and began touting the effectiveness of oral semaglutide, the active ingredient in Novo’s Wegovy, which produced nearly 17% weight loss in separate trials.

When Wegovy’s pill was approved around the new year, Novo and its telemedicine partners launched a high-profile promotional campaign. Advertisements covered New York subways and television broadcasts. The Danish pharmaceutical company also featured celebrities like DJ Khaled in its first-ever Super Bowl ad.

Novo touted the pill’s low entry price of $149 a month and its injection-like effects. The company used Lilly’s three-month lead to shape its story and counter concerns that people didn’t want a pill that had to be taken first thing in the morning without eating or drinking much water. Novo CEO Mike Doosder said the concerns were “fueled a little bit by our competitors.”

“Well, I have news: This is simply not true,” Dusdahl told CNBC in March. “People are very interested because this is the most effective drug on the market right now.”

Wegovy tablets, and now Lilly’s proprietary oral medicine, are helping to expand the GLP-1 market, reaching patients who otherwise would not have received treatment due to fear of needles or difficulty accessing injections, which were once much more expensive for many patients than current tablets.

“There are a significant number of patients who don’t want to be pricked by a needle or be pricked by the price of a vial or syringe,” Jamie Miller, head of Novo’s U.S. operations, said in an interview in March.

People are choosing GLP-1 pills over injections from telemedicine platform Sesame “by a large margin,” said Michael Botta, president and co-founder. He attributes their preference to the lower cost of tablets compared to injectable drugs and the fact that people are more comfortable trying oral drugs than direct injections.

This could potentially bring a wider variety of patients into this category. He said while women still make up the majority of new patients, “definitely” more men are starting the medication than before.

Shortly after its launch, Novo said many of its early users were taking the lowest starting dose. Miller told CNBC that the company is watching closely to see how many patients move up to the highest dose in the coming months.

Looks like Eli Lilly has some work to do to catch up with Novo.

While Novo was able to quickly capitalize on Wegovy’s brand recognition, Lilly is introducing an entirely new brand to people. The company’s Foundayo pill contains a different active ingredient than its best-selling weight loss drug Zepbound. Lilly executives last week sought to reassure investors that it would take time to introduce the drug to doctors and patients.

Lilly CEO Dave Ricks told CNBC after the company’s first-quarter earnings report that more than 20,000 people started taking Foundayo in the first few weeks of its release. More than 1,000 people are starting the drug every day, and 80% of them are first-time patients on the GLP-1 drug, he said. Ricks said Lilly still needs to raise consumer awareness about the pill, adding that the company has not yet started widely advertising the pill on television.

“So what we’re seeing right now is basically essential demand, and that’s very strong for us,” Ricks said.

RBC analyst Chun Huynh said investors should wait two to three months to gauge the momentum of Lilly’s Foundayo launch because there has been so much early volatility. He thinks it will take a year or two for the story to unfold. He pointed to the market for weekly shots. Despite being launched two years after Zepbound was introduced in the US, prescriptions for Zepbound exceeded prescriptions for Novo’s Wegovy in six months.

Emily Field, an analyst at Barclays, said Lilly raised its full-year sales forecast on the strength of its overall GLP-1 business, which should relieve some pressure on Foundayo’s prescriptions in the near term. The company plans to roll out Foundayo in other countries later this year, touting the pill as key to reaching people around the world.

Novo has not provided details about the potential launch of Wigovy tablets outside the United States, but in March it announced a $500 million manufacturing investment in Ireland to meet current and future demand for its oral product outside the United States. The European Medicines Agency is expected to approve Wigovy tablets later this year.

Investors will learn more about Wigovy tablets’ performance this week when the company reports first-quarter earnings, now available in the United States. Analysts are praising the strength of this development, which outpaces even the pill launch.

Still, Wall Street expects overall sales to decline sharply this quarter as generic competition for the Wegovy shot in India, China and Canada threatens sales. The low cost of the tablets could also weigh on sales in the United States.

Investors will be keeping a close eye on any data related to Wigovy pills and whether Novo supports the bleak outlook it announced in February that both sales and profits would decline between 5% and 13% in 2026. Novo’s pipeline will also be a focus. The clinic disappointment has weighed on the stock, leaving investors wondering whether Novo’s pipeline is deep enough to keep the company competitive.

And while the drug is important to both Novo and Lilly, analysts say it won’t define them.

“Yes, it’s shaking things up, but I still think there’s plenty of good stuff in Lilly,” BMO’s Sagerman said. “And Novo may win this one, but he needs multiple wins to become champion.”

Correction: This article has been updated to correct Michael Botta’s title. A previous version had his title incorrectly listed.