Investors moved quickly to reward Novo Nordisk and Eli Lilly after early indicators from oral weight-loss drugs hinted the market could grow beyond current injectable users. Novo said first-quarter sales of its newly launched Wegovy pill were about twice expectations, while Lilly has raised its profit forecast following rising volumes for its weight-loss treatments, which remain largely dominated by injectable GLP-1 medicines.
Analysts and investors interpreting the early data stressed that the initial prescription trends support the idea that pills can expand total market demand instead of simply reallocating existing patients from injections. That distinction matters for both companies' growth outlooks and valuations at a time when pricing pressure is already weighing on realised revenues.
"The product appears to be expanding the market at this stage of launch," said Shams Afzal, managing director at Novo investor Carnegie Investment Counsel, adding the pill offers an easier route to start treatment. "The fear of syringes may have kept a notable segment of the population from considering the injectables before." The U.S. obesity population is large - more than 100 million Americans have obesity - yet only a fraction are currently on GLP-1 therapies, underscoring scope for expansion if oral options attract new users.
Market reaction reflected these dynamics. Novo’s share move followed its disclosure of stronger-than-expected Wegovy pill sales in the first quarter. Lilly’s recent profit upgrade came as Foundayo sales grew after its launch months after Novo’s oral offering. Investors noted the early figures point toward incremental demand rather than a straightforward transfer of patients between delivery formats.
Still, analysts warned it remains early days for oral GLP-1s, and Novo faces specific challenges in reviving growth that has slowed since 2024. Yet even with that caveat, several market participants pointed to uptake that has outpaced prior forecasts.
"We have been very impressed by the willingness of users to self-pay and how fast the pills have caught on," said Jyske Bank analyst Henrik Hallengreen Laustsen, who now sees pills taking 35-40% of the market, above earlier forecasts of 15-20%.
Analysts attributed part of Novo’s sales surge to stockpiling by wholesalers and online pharmacies, but said that underlying demand still exceeded expectations once that effect was stripped out. Importantly, a notable share of early pill users appear to be patients new to GLP-1 therapy rather than switchers from injectables.
"I don’t think it is going to cannibalise patients who are already happy with an injectable," said BMO Capital analyst Evan Seigerman. "It is another way for both Novo and Lilly to get to patients who don’t want an injectable." Novo’s chief executive, Mike Doustdar, told a media call that close to 80% of Wegovy pill users were "GLP-1 treatment-naive patients", a metric industry observers cited as evidence of expansion into fresh patient cohorts.
Citi analysts reported weekly prescriptions for the Wegovy pill reached about 207,000 by mid-April, noting the uptake suggests room for both Novo and Lilly to grow rather than triggering "a cannibalisation event" between pill and injectable formats.
Lilly provided parallel early-use data: more than 8,000 doctors had prescribed Foundayo since its U.S. launch in April, and about one-third of those prescribers had not previously written prescriptions for oral GLP-1 drugs. Distribution channels also differed: roughly 45% of early Foundayo volume flowed through LillyDirect, the company’s direct-to-consumer platform, while Novo said about 50% of Wegovy volumes were self-pay.
Pricing dynamics, however, remain a significant uncertainty. Novo’s adjusted U.S. sales fell 11% in the first quarter due to lower realised prices, and Lilly experienced a similar pattern though it reportedly absorbed the impact more effectively. Shareholders and portfolio managers emphasised that price erosion and competitive pressures could limit upside from expanded demand.
"Novo currently leads in pills but faces risks from further price erosion and looming biosimilar competition in injectables," said Markus Manns, at Novo and Lilly shareholder Union Investment, urging diversification beyond obesity and diabetes. Such strategic choices could shape how each company translates early prescription momentum into sustained growth.
Other investors emphasised the broader market implications of the early pill data. Alessandro Valentini, portfolio manager at Novo shareholder Causeway Capital, summarized the takeaway as the pills reaching new users. "I think that’s what’s really exciting, because the conversation has been so much about Novo versus Lilly... And these are new scripts, new people that weren’t getting the drug before, (now) they are getting the drug," he said. "It’s not a zero-sum game. It’s an expanding market."
Data points cited in this report include:
- First-quarter Wegovy pill sales were about twice expectations, according to Novo’s disclosure.
- Weekly prescriptions for the Wegovy pill reached about 207,000 by mid-April, per Citi analysts.
- More than 8,000 doctors had prescribed Foundayo since its U.S. launch in April, with roughly one-third new to oral GLP-1 prescriptions.
- Approximately 45% of early Foundayo volume came through LillyDirect; about 50% of Wegovy volumes were self-pay.
- Novo’s adjusted U.S. sales fell 11% in Q1 due to lower realised prices.