The global weight-loss drug market, once dominated by Novo Nordisk, is undergoing a dramatic transformation.
On Friday, the Danish pharmaceutical giant announced it would replace its long-serving chief executive, Lars Fruergaard Jorgensen, as the company faces mounting pressure from rivals and a sharp slide in its stock value.
Novo’s shares have fallen 50% over the past year, a stunning reversal for the maker of Wegovy and Ozempic, two of the most recognisable names in obesity and diabetes care.
Analysts expect the weight-loss drug market to expand significantly in the next decade, potentially reaching $100 billion globally.
Jorgensen’s ouster signals deeper turmoil at the heart of the fast-evolving market, where GLP-1 drugs—once seen as miracle treatments—are now facing stiffer competition and growing scrutiny from insurers and policymakers.
Eli Lilly’s rise reshapes market leadership
The most formidable challenger has emerged in the form of US-based Eli Lilly, whose GLP-1 injection Zepbound has steadily gained market share against Novo’s Wegovy.
Lilly’s latest clinical data has only solidified its momentum.
A recent late-stage trial showed that orforglipron, the company’s experimental pill, helped diabetes patients lose nearly 8% of their body weight in 40 weeks—beating Ozempic’s performance in a similar cohort.
Lilly also boasts retatrutide, a weekly injection that delivered 24.2% weight loss in a mid-stage trial, one of the strongest results in the sector so far.
The company expects to seek approval for orforglipron by year-end and continues to invest aggressively, including a recent deal with Chinese biotech Laekna to develop a muscle-preserving obesity drug.
Novo races to catch up with next-generation drugs
To reclaim lost ground, Novo Nordisk is banking on new treatments.
It is developing amycretin in both pill and injectable form.
Early trial data suggest significant weight-loss potential, with the injectable version helping patients lose 22% of their body weight in 36 weeks.
The company is also pushing forward with CagriSema, though late-stage trial results have underwhelmed, falling short of internal benchmarks.
Novo hopes to submit CagriSema for regulatory approval in early 2026.
It has also broadened its pipeline through partnerships, including a $2 billion licensing agreement with United Laboratories for a triple-hormone targeting obesity drug.
Source: The Economist
Roche, Amgen also join the bandwagon
Lilly and Novo are no longer alone in the race. A host of major pharmaceutical companies and biotech firms are piling into the obesity space, lured by the multibillion-dollar market opportunity.
Pfizer recently dropped out after safety concerns in a trial involving danuglipron, its oral GLP-1 candidate.
But others are forging ahead. Roche has made big bets, acquiring Zealand Pharma’s petrelintide and Carmot Therapeutics’ CT-388, both GLP-1-based drugs, for a combined $8 billion.
Early data on Carmot’s second candidate also appears promising.
Amgen’s MariTide, an experimental drug that led to 20% weight loss in a mid-stage trial, is set to begin late-stage studies by mid-year.
Analysts note that the drug’s side effects may be more pronounced than competitors’, but its efficacy places it among the front-runners.
Merck, AstraZeneca, smaller firms also seek a slice of the market
Pharma giants traditionally absent from obesity treatments are now seeking a slice of the market.
In December, Merck struck a $2 billion licensing deal for a GLP-1 pill developed by Hansoh Pharma.
AstraZeneca’s licensed candidate AZD5004 has cleared early safety hurdles and is in mid-stage trials.
Smaller firms are also showing potential. Altimmune’s pemvidutide posted a 15.6% average weight loss in trials, although with notable gastrointestinal side effects.
Viking Therapeutics reported nearly 15% weight loss in 13 weeks with its injectable VK2735, and Zealand Pharma’s petrelintide posted 8.6% average weight loss in an early study.
Structure Therapeutics, meanwhile, has shown modest success with its oral candidate GPCR, delivering 6.2% weight loss over 12 weeks.
While not as potent as rivals, the convenience of an oral drug remains attractive to patients and investors alike.
Access remains an issue
Despite scientific advancements, access to these drugs remains a critical issue.
Employers are struggling with rising health coverage costs, leading many to exclude weight-loss drugs from their insurance plans.
Medicare still does not reimburse for obesity treatments in most cases.
A Biden administration plan to expand coverage was recently struck down by the Trump administration, leaving most patients to pay out of pocket. At an average of $500 per month, affordability remains a barrier for millions.
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