The booming GLP-1 space was built on weekly injections. In 2026, new pills against obesity will push the market towards its next chapter.
Patients are already getting their hands on the first GLP-1 pill against obesity from the Danish drug manufacturer Novo Nordisk – a once-a-day medication that shares the same brand name as its popular Wegovy injection. A GLP-1 pill of the company’s main rival Elie Lilly is not far behind, with US approval expected within a few months.
For some people, pills may be a more convenient – and potentially cheaper – alternative to today’s blockbuster injections. The cash prices of the Wegovy pill from Novo Nordisk range from $149 to $299 per monthdepending on the dose, which is slightly lower than the recently reduced spot prices of the injections.
Although the pills are not expected to cause more weight loss than weekly injections, based on separate clinical trials, some health experts say expanding the range of treatments could still be a major win for patients.
The pills could entice new patients to seek obesity treatment for the first time, expanding the broader market for weight loss and diabetes drugs and potentially boosting sales of Novo Nordisk and Eli Lilly. New users may include people who are afraid of needles, as well as patients who might benefit from existing injections but who don’t consider their condition serious enough to warrant a weekly injection.
“I think there are a lot of people who have never tried these GLP-1 drugs and may be waiting for the pills to come out,” said Dr. Eduardo Grunvald, medical director of the UC San Diego Health Center for Advanced Weight Management. “It’s a natural preference for some people and even for some prescribers.”
“Secondly, if you have to pay out of pocket, the pills will be a little cheaper than the injections, so that’s another reason,” he explained.
The logo of pharmaceutical company Novo Nordisk is displayed in front of its offices in Bagsvaerd, a suburb of Copenhagen, Denmark, November 24, 2025.
Tom Petit | Reuters
It’s unclear how many people are currently using GLP-1 in the United States, particularly to combat obesity. But about 1 in 8 adults said they were taking a GLP-1 drug to lose weight or treat another chronic condition in November, according to a study. survey from the health policy research organization KFF.
Today, the pills appear as next battlefield for Novo Nordisk and Eli Lilly, which created the GLP-1 space that some analysts say could be worth nearly $100 billion by the 2030s. In August, Goldman Sachs analysts predicted the pills could capture about 24% — or about $22 billion — of the global weight-loss drug market by 2030.
Here’s how obesity pills could reshape space.
Pills could expand market Oral medications could attract new patients to the obesity treatment market.
“I think it will expand the market significantly,” Novo Nordisk CEO Mike Doustdar told CNBC in late December. “We know from our own family members and circles of friends that many people would still not prefer to have an injection…for this group of people, having the option of the pill is important.”
The pills might prompt some people to start obesity treatment because “they think it’s somehow more acceptable or more accessible” than an injection, said Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital.
This does not mean that one pill will be best for everyone. But once patients enter the health system for treatment, doctors can guide them through all the options — whether it’s an injection, metabolic surgery or a structured diet and exercise program, Apovian said.
UCSD’s Grunvald said adoption of obesity pills would likely be driven by primary care doctors, who treat the majority of eligible patients and may be more comfortable prescribing an oral drug.
Grunvald said obesity medicine specialists, who treat only about 5 to 10 percent of eligible patients, are more likely to continue favoring injections, which appear more effective than pills, based on separate clinical trials.
Deborah, a 53-year-old librarian in St. Louis, Mo., said she was curious about the new Wegovy pill, in part because of its convenience factor. She declined to give her last name due to concerns about the stigma associated with GLP-1s.
Deborah said she would consider an oral GLP-1 because she is already used to taking pills over other prescriptions. She said an oral medication would also provide other benefits, such as making it easier to travel because it wouldn’t require refrigeration, as injections do.
She said she was also interested in the potentially lower cost of the pills. Deborah has been taking weekly Wegovy injections since June and was paying $449 per month in cash before Novo Nordisk lowered that price to $349 per month.
The pills cost a little lessCost could also be a factor for other patients.
Novo Nordisk’s pill appears to have one of the lowest cash prices on the market, at $149 per month for the starting dose and $299 per month for the two highest doses. Eli Lilly’s rival pill is expected to have a similar price for patients paying cash.
These users will also be able to access the starting dose of both pills for $149 per month through President. Donald TrumpThe direct-to-consumer website, TrumpRx, under an agreement concluded by the two companies with his administration in November.
Obesity shots have long been difficult for patients to obtain, in part because of spotty insurance coverage and list prices of around $1,000 a month. Both Novo Nordisk and Eli Lilly decided to address these concerns by reducing the cash price of their injectable drugs to less than half that amount.
A combined image shows an injector pen of Zepbound, Eli Lilly’s weight-loss drug, and boxes of Wegovy, made by Novo Nordisk.
Hollie Adams | Reuters
Eli Lilly said in December that highest doses of single dose vials of Zepbound will cost $449 per month for patients paying cash, while Novo Nordisk said in November almost every dose of Wegovy will cost $349 per month in cash.
These prices are closer to the cost of Novo Nordisk’s pill, which can still be expensive for some. But Grunvald said the monthly difference of about $150 between the highest doses of Zepbound and Novo’s pill “could be a big difference for many people” willing to pay out of pocket.
Patients with insurance coverage for Novo Nordisk’s oral medication can pay as little as $25 per month for treatment. But the pills probably won’t do much to boost insurance coverage of GLP-1s against obesity in the United States.
Direct-to-consumer cash prices for Novo Nordisk’s oral drug are likely “significantly lower” than what employers and middlemen called pharmacy benefit managers would pay to cover the drugs, said John Crable, senior vice president of Corporate Synergies, an insurance and benefits brokerage and consulting firm.
Crable said it’s unclear how much the pill will ultimately cost payers such as employers. since these prices are not made public. But if they reflect injection costs — often more than $1,000 a month — employers might be reluctant to add the drug to their formularies, he said.
Some companies that already offer coverage for obesity shots may add the pills this year. But Crable said some employers have actually dropped GLP-1 coverage for obesity in 2026 because of their high costs.
“I don’t see employers being very motivated to add what will likely be another high-volume, very expensive drug to their list when the direct-to-consumer price is much cheaper,” Crable said.
Injections are here to stay Drugmakers have tried to argue that patients using injections can easily switch to oral medications. Eli Lilly in December published data showing that patients who initially took Wegovy or Zepbound injections maintained the majority of their weight loss after switching to the company’s pill.
But Apovian, of Brigham and Women’s Hospital, said cost would be the only real reason to move patients who do well on injections to a pill.
“If the [cash price] is similar, I still prefer injectables because I think the weight loss is better and the side effects are less,” she said.
Apovian said it wants to see real-world data on how the pills work compared to injections, but separate late-stage trials already offer some clues.
Zepbound has shown an average weight loss of more than 20% in late-stage studies. That’s higher than results seen with Wegovy’s injection and pill as well as Eli Lilly’s oral medication in separate trials.
In these same studies, about 7% or fewer of patients stopped treatment due to side effects from Zepbound and Wegovy injections.
The Wegovy pill showed similar discontinuation rates, while approximately 10.3% of patients taking the highest dose of Eli Lilly’s oral medication stopped treatment due to side effects.
David Risinger, an analyst at Leerink Partners, said obese patients who need to lose a larger percentage of their body weight will likely stick with injections unless they are afraid of needles.
The pills, he said, could attract mainly new patients who are overweight or slightly obese and want only “modest” weight loss.
Some patients currently using weekly injections may try pills, Risinger added, although not everyone will find a daily oral option more convenient.
That includes Karen Galante, 42, of Horsham, Pa., who takes a compounded version of semaglutide — the active ingredient in Wegovy — which she says is priced similar to that him of the new pill from Novo Nordisk.
Galante said she has no plans to change.
“It’s hard enough for me to remember to take my vitamins every day,” she said. “I like that I take one photo a week and forget about it.”
More than enough for Novo, LillyRisinger said he expects both Novo Nordisk and Eli Lilly to “take off like a rocket” this year.
He noted that adoption will be greater for the Wegovy pill initially since Eli Lilly’s drug, or forglipron, is likely still months away from entering the market.
But Risinger said he thinks Eli Lilly’s pill will ultimately generate higher sales because patients might view it as more convenient.
Eli Lilly’s orforglipron is a small molecule drug that is absorbed more easily by the body and does not require dietary restrictions like Novo Nordisk’s pill, which is a peptide drug. Patients are not supposed to drink more than four ounces of water with the Wegovy pill and should wait 30 minutes before eating or drinking anything else each day.
But Novo Nordisk CEO Doustdar argued that these dietary requirements would not hinder consumption. He told CNBC in December that this was not a problem for more than a million people who take the low-dose version of the diabetes pill, marketed as Rybelsus, which entered the market in 2019.
“Just sip and go, and you’ll be fine,” Doustdar said. “These people wake up in the morning and take their pill with a glass of water, then they return to their normal daily routine half an hour later and continue with their lives.”
He also called the company’s drug “the most effective pill,” saying no other product in development has been able to demonstrate the same level of weight loss in a late-stage trial.
The highest dose of Novo Nordisk’s Wegovy pill helped patients lose up to 16.6% of their weight on average at 64 weeks in a late-stage study. This is comparable to the injectable form of the drug.
There are no comparative studies directly comparing this pill to Eli Lilly. In one of Eli Lilly’s late-stage trials, the highest dose of its pill helped patients lose 12.4% of your weight on average at 72 weeks.
Despite this difference in effectiveness, Risinger said the two pills are considered to promote roughly similar levels of weight loss. Some patients may not need to take the highest dose of either pill, he added.
In an August note, Goldman analysts said they expected Eli Lilly’s pill to have a 60% share — or about $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 about $4 billion — of that segment. Analysts said they expect the remaining 19% to be devoted to other emerging pills.
New competitors emergeOther drugmakers are rushing to bring their own oral options to market, including Pfizer, AstraZeneca, Structured therapy And Viking Therapeutics.
Risinger highlighted Structure’s daily oral GLP-1, which will enter phase three trials later this year. Structural actions climbed over 100% December 9 after data published mid-term demonstrating that its pill, aleniglipron, helped obese patients lose more than 11% of their weight at 36 weeks, after adjusting for placebo.
Additional trial data showed that a higher dose of the pill could provide greater effectiveness – more than 15% weight loss – surpassing the results seen with the highest dose of Eli Lilly’s orforglipron. Still, the data on tolerability, or how well patients tolerated Structure’s treatment, seemed worse than those for Eli Lilly’s pill.
In a statement at the time, Structure CEO Raymond Stevens said the pill could be “potentially best-in-class” for an oral GLP-1 small molecule.
Risinger said he expects that pill and another oral GLP-1 from AstraZeneca could be launched as soon as late 2028.
He said potential pills that are taken weekly, rather than daily, and have “compelling profiles could tip the scales more toward the oral route” in the market.
Risinger highlighted the private company Verdiva Biowhich is developing several oral peptide treatments intended to be taken once a week. This company is currently conducting a phase two trial of an oral GLP-1.
