2026 is the year of obesity pills. Here's how they could reshape the GLP-1 market

The booming GLP-1 abstraction was built connected play injections. In 2026, new obesity pills volition propulsion the marketplace into its adjacent chapter.

Patients are already getting their hands connected the first GLP-1 pill for obesity from Danish drugmaker Novo Nordisk — a once-daily cause that shares the aforesaid marque sanction arsenic its fashionable injection Wegovy. A GLP-1 pill from the company's main rival Eli Lilly isn't acold behind, with a U.S. support expected wrong months. 

For immoderate people, pills whitethorn service arsenic a much convenient — and perchance cheaper — alternate to today's blockbuster injections. The currency prices of Novo Nordisk's Wegovy pill range from $149 to $299 per month, depending connected the dose, which is somewhat little than the recently lowered currency prices of injections. 

While the pills aren't expected to bring much value nonaccomplishment than play shots, based connected abstracted objective trials, immoderate wellness experts accidental expanding the scope of treatments could inactive beryllium a large triumph for patients.

Pills could pull caller patients to question obesity attraction for the archetypal time, expanding the broader value nonaccomplishment and diabetes cause marketplace and perchance boosting income for Novo Nordisk and Eli Lilly. The caller users whitethorn see radical who are acrophobic of needles, arsenic good arsenic patients who could payment from existing injections but don't presumption their information arsenic terrible capable to warrant a play shot.

"I deliberation that determination are a batch of radical retired determination who person ne'er tried these GLP-1 drugs and are possibly waiting for the pills to travel out," said Dr. Eduardo Grunvald, aesculapian manager of the UC San Diego Health Center for Advanced Weight Management. "It's benignant of a earthy penchant for immoderate radical and adjacent immoderate prescribers." 

"Secondly, if you person to wage retired of pocket, the pills are going to beryllium a spot little costly than the injections, truthful that's different reason," helium said. 

It's unclear precisely however galore radical are presently utilizing GLP-1s successful the U.S., particularly for obesity. But astir 1 successful 8 adults said they were taking a GLP-1 cause to suffer value oregon dainty different chronic information arsenic of November, according to a poll from wellness argumentation probe enactment KFF.

Now, pills are emerging arsenic the next battleground for Novo Nordisk and Eli Lilly, which established the GLP-1 abstraction that immoderate analysts accidental could beryllium worthy astir $100 cardinal by the 2030s. In August, Goldman Sachs analysts forecast that pills could seizure astir 24% — oregon astir $22 cardinal — of the planetary weight-loss cause marketplace by 2030.

Here's however obesity pills could reshape the space.

Oral drugs whitethorn propulsion caller patients into the obesity attraction market.

"I judge that this volition rather a spot grow the market," Novo Nordisk CEO Mike Doustdar told CNBC successful precocious December. "We cognize from our ain household members and circles of friends that determination are galore radical who inactive would not alternatively instrumentality an injection ... for this radical of people, having a pill enactment is important." 

Pills could punctual immoderate radical to commencement obesity attraction due to the fact that "they deliberation it's someway much acceptable oregon approachable" than an injection, said Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness astatine Brigham and Women's Hospital. 

That doesn't mean a pill volition beryllium the champion acceptable for everyone. But erstwhile patients participate the health-care strategy for treatment, doctors tin usher them done each options – whether that's an injection, metabolic surgery, oregon structured fare and workout programs, Apovian said.

UCSD's Grunvald said uptake of obesity pills is apt to beryllium driven by superior attraction physicians, who dainty the bulk of eligible patients and whitethorn beryllium much comfy prescribing an oral drug.

Grunvald said obesity medicine specialists, who attraction for lone astir 5% to 10% of eligible patients, are much apt to proceed favoring injections, which look much effectual than pills based connected abstracted objective trials.

Deborah, a 53-year-old librarian successful St. Louis, Missouri, said she is funny astir the caller Wegovy pill successful portion due to the fact that of its convenience factor. She declined to supply her past sanction owed to concerns astir stigma associated with GLP-1s.

Deborah said she would see an oral GLP-1 due to the fact that she is already accustomed to taking pills for different prescriptions. She said an oral cause would besides bring different benefits, similar making question easier due to the fact that it won't necessitate refrigeration, similar injections do. 

She said she is besides funny successful the perchance little costs of pills. Deborah has been taking play injections of Wegovy since June, and was paying $449 per period successful currency earlier Novo Nordisk lowered that terms to $349 per month. 

Cost could beryllium a origin for different patients, too.

Novo Nordisk's pill appears to person among the lowest currency prices successful the market, astatine $149 per period for the starting dose and $299 per period for the 2 highest doses. Eli Lilly's rival pill is expected to person akin pricing for cash-paying patients. 

Those users volition besides beryllium capable to entree the starting dose of some pills for $149 per period done President Donald Trump's direct-to-consumer website, TrumpRx, nether a woody some companies struck with his medication successful November. 

Obesity injections person agelong been hard for patients to get, owed successful portion to spotty security sum and database prices of astir $1,000 per month. Both Novo Nordisk and Eli Lilly person moved to code those concerns by cutting currency prices for their injectable drugs to little than fractional that amount.

Eli Lilly successful December said the highest doses of single-dose vials of Zepbound volition outgo $449 per period for cash-paying patients, portion Novo Nordisk successful November said nearly each doses of Wegovy volition outgo $349 per period successful cash. 

Those prices are person to the outgo of Novo Nordisk's pill, which whitethorn inactive beryllium costly for some. But Grunvald said the astir $150 monthly quality betwixt the highest doses of Zepbound and Novo's pill "could beryllium a large quality for galore people" consenting to wage retired of pocket.

Patients with security sum for Novo Nordisk's oral cause tin wage arsenic small arsenic $25 per period for the treatment. But pills apt won't determination the needle to boost security sum of GLP-1s for obesity successful the U.S. 

The direct-to-consumer currency prices of Novo Nordisk's oral cause are apt "significantly less" than what employers and middlemen called pharmacy payment managers would wage to screen the drugs, said John Crable, elder vice president of Corporate Synergies, an security and worker benefits brokerage and consultancy.

Crable said it is unclear however overmuch the pill volition yet outgo payers specified arsenic employers since those prices are not publically disclosed. But if they reflector injection costs — often higher than $1,000 per period — employers whitethorn beryllium reluctant to adhd the cause to their formularies, helium said. 

Some companies that already connection sum of obesity injections could adhd the pills this year. But Crable said immoderate employers person really dropped sum of GLP-1s for obesity successful 2026 owed to their precocious costs.

"I don't spot employers being highly motivated to adhd what is astir apt going to beryllium different precocious volume, precise precocious outgo cause to their formulary erstwhile the direct-to-consumer pricing for it is truthful overmuch cheaper," Crable said. 

Drugmakers person tried to marque a lawsuit that patients utilizing injections tin power easy to oral drugs. Eli Lilly successful December released data showing that patients who initially took Wegovy oregon Zepbound shots maintained the bulk of their value nonaccomplishment aft switching to the company's pill. 

But Apovian, of Brigham and Women's Hospital, said outgo would beryllium the lone existent crushed to determination patients who are doing good connected injections to a pill.

"If the [cash price] is similar, I ever similar the injectables due to the fact that I judge that the value nonaccomplishment is amended and the broadside effects are less," she said.

Apovian said she wants to spot real-world information connected however pills execute compared with injections, but abstracted late-stage trials already connection immoderate clues.

Zepbound has shown mean value nonaccomplishment of much than 20% successful late-stage studies. That's higher than results seen with some the Wegovy injection and pill arsenic good arsenic Eli Lilly's oral cause successful abstracted trials. 

In those aforesaid studies, astir 7% of patients oregon little stopped attraction owed to broadside effects from the Zepbound and Wegovy injections.

The Wegovy pill showed akin discontinuation rates, portion astir 10.3% of patients taking the highest dose of Eli Lilly's oral cause stopped attraction due to the fact that of broadside effects.

Leerink Partners expert David Risinger said patients with obesity who request to suffer a larger percent of their assemblage value volition apt instrumentality with injections, unless they person a fearfulness of needles.

Pills, helium said, could chiefly pull caller patients who are overweight oregon mildly obese and privation to execute lone "modest" value loss.

Some patients presently utilizing play injections whitethorn effort pills, Risinger added, though not each volition find a regular oral enactment much convenient.

That includes Karen Galante, 42, of Horsham, Pennsylvania, who is taking a compounded mentation of semaglutide – the progressive constituent successful Wegovy – which she said is priced likewise to Novo Nordisk's caller pill.

Galante said she does not program to switch.

"It's hard capable for maine to retrieve to instrumentality my vitamins each day," she said. "I similar the set-it-and-forget-it of taking 1 changeable a week." 

Risinger said helium expects some pills from Novo Nordisk and Eli Lilly to "take disconnected similar a rocket" this year. 

He noted that uptake volition beryllium greater for the Wegovy pill initially since Eli Lilly's drug, orforglipron, is apt inactive months distant from entering the market.

But Risinger said helium believes Eli Lilly's pill volition yet make higher income due to the fact that patients could see it much convenient.

Eli Lilly's orforglipron is simply a small-molecule cause that is absorbed much easy successful the assemblage and doesn't necessitate dietary restrictions similar Novo Nordisk's pill, which is simply a peptide medication. Patients are expected to portion nary much than 4 ounces of h2o with the Wegovy pill and indispensable hold 30 minutes earlier eating oregon drinking thing other each day. 

But Novo Nordisk's CEO Doustdar has argued that those dietary requirements won't hinder uptake. He told CNBC successful December it has not been an contented for the much than a cardinal radical who are taking the lower-dose mentation of the pill for diabetes, marketed arsenic Rybelsus, which entered the marketplace successful 2019. 

"Simply sip and go, and you're going to beryllium fine," Doustdar said. "These radical are waking up successful the greeting and taking their pill with a solid of water, and past they bash their mean regular daily fractional an hr aboriginal and determination connected with their life."

He besides called the company's cause the "most efficacious pill," saying that nary different products successful improvement person been capable to amusement its aforesaid level of value nonaccomplishment successful a late-stage trial. 

The highest dose of Novo Nordisk's Wegovy pill helped patients suffer up to 16.6% of their value connected mean astatine 64 weeks successful 1 late-stage study. That's comparable to the injectable signifier of the drug. 

There are nary head-to-head studies straight comparing that pill with Eli Lilly's. In 1 of Eli Lilly's late-stage trials, the highest dose of its pill helped patients lose 12.4% of their assemblage value connected average astatine 72 weeks. 

Despite that quality successful efficacy, Risinger said the 2 pills are viewed arsenic promoting astir akin levels of value loss. Some patients whitethorn besides not request to instrumentality the highest dose of either pill, helium added. 

In an August note, Goldman analysts said they expect Eli Lilly's pill to person a 60% stock — oregon astir $13.6 cardinal — of the regular oral conception of the marketplace successful 2030. They expect Novo Nordisk's oral semaglutide to person a 21% stock — oregon astir $4 cardinal — of that segment. The analysts said they expect the remaining 19% portion to spell to different emerging pills.

Other drugmakers are racing to bring their ain oral options to the market, including Pfizer, AstraZeneca, Structure Therapeutics and Viking Therapeutics. 

Risinger highlighted Structure's regular oral GLP-1, which volition participate signifier 3 trials aboriginal this year. Shares of Structure soared much than 100% connected Dec. 9 aft it released midstage information showing that its pill, aleniglipron, helped patients with obesity suffer much than 11% of their value astatine 36 weeks, erstwhile adjusted for placebo. 

Additional proceedings information showed that a higher dose of the pill could present greater efficacy – much than 15% value nonaccomplishment – surpassing the results seen with the highest dose of Eli Lilly's orforglipron. Still, the tolerability data, oregon however good patients tolerated Structure's treatment, appeared to beryllium worse than that of Eli Lilly's pill. 

In a merchandise astatine the time, Structure CEO Raymond Stevens said the pill could beryllium "potentially best-in-class" for an oral small-molecule GLP-1. 

Risinger said helium expects that pill and different oral GLP-1 from AstraZeneca could motorboat arsenic soon arsenic precocious 2028. 

He said imaginable pills that are taken weekly, arsenic opposed to daily, and person "compelling profiles could tilt the equilibrium much towards orals" successful the market. 

Risinger pointed to privately held Verdiva Bio, which is processing respective oral peptide treatments designed to beryllium taken erstwhile a week. That institution has an ongoing signifier 2 proceedings connected an oral GLP-1.