Healthy Returns: 2026 will be the year of obesity pills from Novo Nordisk, Eli Lilly

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GLP-1 pills for obesity are closer than ever. 

2026 is likely the year that two new oral weight loss drugs will reach patients in the U.S. For some people, pills may serve as a more convenient — and potentially in certain cases cheaper — alternative to today's blockbuster injections.

Drugmakers Novo Nordisk and Eli Lilly have said their daily pills could help the drugs reach new patients. That could include people who are afraid of needles or patients who might benefit from the existing injections but don't take them because they don't view their need as severe enough. 

The upcoming pills aren't expected to be more effective than weekly injections, but health experts stress that expanding the range of treatment options could still be a major win for patients. After the injections hit nationwide supply shortages in recent years, Novo Nordisk and Eli Lilly have already started preparing enough of their pills to meet expected demand. 

In a note in August, Goldman Sachs analysts forecasted that pills will capture a 24% share — or around $22 billion — of the 2030 global weight loss drug market, which they expect to be worth $95 billion in total.

Here's what to know about the upcoming pills.  

Most importantly, Novo Nordisk could beat its rival to the market. The Danish drugmaker's oral semaglutide, the active ingredient in its obesity injection Wegovy and diabetes shot Ozempic, is slated to win approval by the end of the year. 

That sets up the drug, which will be marketed as Wegovy in a pill, to launch early next year. 

Meanwhile, Eli Lilly has not yet filed for approval of its oral GLP-1, orforglipron, but the company is preparing to do so by the end of the year. The Food and Drug Administration in November said it has awarded a priority review voucher to that pill, which could expedite the review timeline for the drug to a few months. 

It's unclear exactly when that approval could be, but it's safe to say that the pill will enter the market sometime in 2026. 

Neither drugmaker has released specific list prices for their pills. But we already know that they're planning discounts for patients. 

Under recent deals with President Donald Trump, the companies said starting doses of their upcoming pills, pending approvals, will be $149 per month for everyone getting them through the direct-to-consumer website TrumpRx. That site launches in January. 

That's already cheaper than the planned discounted prices for Novo Nordisk and Eli Lilly's existing injections. Currently, drugs like Wegovy and Eli Lilly's obesity injection Zepbound carry list prices of roughly $1,000 per month before insurance. 

It's difficult to directly compare the results of separate clinical trials on the two drugs to compare their efficacy. What's more, Eli Lilly's ATTAIN-1 trial on its pill followed 3,000 patients with obesity or who were overweight, while Novo Nordisk's OASIS 4 study on its own oral drug evaluated a much smaller group of roughly 300. There are currently no studies directly comparing the two treatments. 

But Novo Nordisk's oral semaglutide appears to cause a greater level of weight loss than Eli Lilly's pill, based on the available data, some analysts have said. 

In Eli Lilly's trial, the highest dose of its pill helped patients lose 12.4% of their body weight on average at 72 weeks. The weight loss achieved using the pill was 11.2% when analyzing all patients regardless of discontinuations.

Meanwhile, the 25-milligram dose of Novo Nordisk's oral semaglutide helped patients lose up to 16.6% of their weight on average at 64 weeks, according to results from the trial presented at a medical conference in 2024. That weight loss was 13.6% when the company analyzed all patients regardless of whether they stopped the drug. 

Still, the slightly lower efficacy of Eli Lilly's pill may not be significant enough to deter patients from taking it.

In the August note, Goldman analysts said they expect Eli Lilly's pill to have a 60% share — or roughly $13.6 billion — of the daily oral segment of the market in 2030. They expect Novo Nordisk's oral semaglutide to have a 21% share — or around $4 billion — of that segment. It expects the remaining 19% slice to go to other emerging pills, the analysts said.

So, who's next? Viking Therapeutics, Structure Therapeutics, AstraZeneca, Roche and Pfizer are developing their own obesity pills, and we'll certainly see more data from those experimental drugs next year. 

Stay tuned for our coverage.

Feel free to send any tips, suggestions, story ideas and data to Annika at a new email: annika.constantino@versantmedia.com.