Eli Lilly’s Foundayo, launched in the US in April, generated US$184 million in third-quarter sales. Its established injectable obesity treatment, Zepbound, brought in US$5.35 billion.

Meanwhile, research on Novo Nordisk’s Wegovy pill suggests oral medicines are attracting patients without recent recorded GLP-1 use as well as those switching from injections. New patients could expand the market, while those switching treatments would largely shift sales between existing products.

This week, Market Watch examines early prescribing trends, competition and who stands to benefit from the next wave of obesity treatments.

Visiongain Top Takeaways

• Novo still leads oral prescriptions: Lilly is gaining a larger share of patients starting pill treatment.
• New patient demand remains uncertain: Truveta found that 41% of patients with recent healthcare records had no recorded prior GLP-1 treatment, although this does not confirm they were first-time users.
• Dosing matters, but it is not everything: Lilly’s simpler routine competes with Novo’s brand recognition and prescribing experience.
• Higher volumes may yield less revenue: Pricing and reimbursement complicate the growth outlook.

Novo Leads Oral Prescriptions, but Lilly Is Gaining Ground

IQVIA figures reported by Fierce Pharma show approximately 183,000 weekly US prescriptions for Wegovy tablets in late October, compared with 63,110 for Foundayo. Tablets now account for 36% of all Wegovy prescriptions, although weekly volumes remain close to their recent peaks.

Lilly says Foundayo accounts for around four in ten people starting an oral obesity treatment, despite its smaller share of total prescriptions.

Total prescriptions include refills, while new treatment starts provide a clearer indication of current competitive momentum. Novo’s earlier launch and established Wegovy brand may help explain its lead, although prescription data do not capture every distribution channel.

Are Tablets Reaching New Patients?

Truveta’s October analysis identified 182,101 patients prescribed Wegovy tablets. Among those with a healthcare encounter in the previous year, 41% had no recorded prior GLP-1 treatment. Across the study population, 26% had most recently used an injectable obesity medicine.

The findings suggest tablets may be reaching previously untreated patients, although incomplete treatment histories make it difficult to establish how many are genuinely new to the market.

Primary care could also help broaden access. General practice clinicians accounted for 83% of prescribers where specialty was known, although this information was available for only 43% of patients.

Whether these patients continue treatment will be important in determining how much additional demand oral medicines generate.

Could Simpler Dosing Give Lilly an Advantage?

Novo Nordisk’s Wegovy pill must be taken on an empty stomach, with patients waiting at least 30 minutes before eating, drinking or taking other oral medicines. Lilly’s Foundayo has no food or water restrictions.

That gives Lilly a simpler dosing routine, although Novo benefits from an established brand and physicians’ familiarity with semaglutide.

Convenience alone is unlikely to determine which medicine patients choose. Efficacy, tolerability and cost will also influence prescribing, and it remains unclear whether Foundayo’s easier dosing will translate into greater market share.

Wider Access Changes the Economics

Wegovy tablets and Foundayo both start at US$149 a month for US patients paying out of pocket, although higher doses can cost US$299 or more.

Access has also widened for some patients. Since July, eligible Medicare beneficiaries have been able to receive either treatment for a US$50 monthly copayment through the temporary GLP-1 Bridge programme.

Lower costs could encourage more people to start treatment, but higher prescription volumes won’t necessarily mean equivalent revenue growth. Lilly’s third-quarter results illustrate the pressure. US sales volumes rose 41%, while realised prices across its US business fell 7%, primarily reflecting Zepbound. These figures cover Lilly’s wider business, not Foundayo alone.

Roche and Pfizer Take Different Routes

Roche has completed a Phase II obesity study of its oral GLP-1 candidate CT-996. Pfizer is developing a potential once-monthly injectable, berobenatide, alongside an oral GLP-1 programme.

The development risks are substantial. Pfizer discontinued Metsera’s oral candidate MET-224o in August, following earlier setbacks in its obesity pipeline.

A successful once-monthly injection could offer another convenient alternative to daily tablets. The next phase of competition may not favour oral medicines as strongly as their early uptake suggests.

Market Outlook

Over the coming quarters, repeat prescriptions, treatment switching and reimbursement decisions should give a clearer picture of how the oral market is developing.

The prices manufacturers receive, and how long patients remain on treatment, will be just as important as prescription growth.

Visiongain Insight

Repeat prescribing, treatment switching and reimbursement decisions will help determine whether early demand becomes lasting growth.

The prices manufacturers receive, and how long patients remain on treatment, will be just as important as prescription growth.

The choice between peptide and non-peptide medicines could also affect manufacturing investment. Wegovy contains the peptide semaglutide, while Foundayo is a non-peptide treatment. Their relative success may influence future demand for specialist peptide manufacturing capacity.

Explore the Anti-obesity Drugs Market

As oral obesity treatments gain ground, how will demand change across delivery formats and regional markets?

Visiongain’s Anti-obesity Drugs Market Report 2026–2036 provides forecasts for oral and injectable treatments, distribution channels and regional markets, alongside competitive analysis to support investment, market entry and expansion decisions.

Explore the report and request a free sample

Related Visiongain Research

Growing demand for peptide-based GLP-1 medicines is also creating opportunities in specialist manufacturing. Our Peptide Contract Manufacturing Market Report 2026–2036 examines manufacturing capacity, outsourcing trends and the competitive landscape across metabolic diseases and other therapeutic areas.

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