New pricing strategies for GLP-1 obesity drugs from Novo Nordisk and Eli Lilly have set the stage for future competitors, according to a new PitchBook report. The report highlights that the inclusion of these approved GLP-1 therapies in Medicare and Medicaid under Most Favored Nation pricing will expand access by an estimated 7 to 15 million patients. This move addresses previous issues with insurance denials and broadens the market for these treatments.
Currently, the TrumpRx agreements apply only to Novo Nordisk and Eli Lilly. However, PitchBook notes that these arrangements will benefit other biotechnology companies developing similar drugs by providing a clearer regulatory pathway and larger patient base.
“Expanded CMS coverage strengthens the case for broader GLP-1 label indications and reinforces long-term cardiometabolic franchise strategies,” PitchBook stated. “Later entrants are positioned to benefit from a clearer regulatory pathway for obesity pharmacotherapy and a larger patient and prescriber base, which may accelerate adoption curves for differentiated products.”
Despite this opportunity, Novo Nordisk and Eli Lilly remain well established in the market due to their existing deals and manufacturing capabilities. New competitors will still need to overcome these barriers.
The report also points out that mergers and acquisitions activity is likely to increase in 2026. One notable event was Pfizer’s $10 billion acquisition of Metsera following competition with Novo Nordisk. According to PitchBook, there are currently 120 assets being developed by 60 companies in this space, suggesting more potential deals ahead.
“As competition for late-stage assets intensifies, acquirers may move upstream, targeting earlier-stage, higher-risk platforms that offer novel biology or delivery modalities,” said PitchBook.
Venture capital investment in biopharma reached its lowest point in the second quarter but began recovering in the third quarter of 2025. This trend is expected to continue into next year as interest rates are predicted to fall further, potentially increasing investor willingness to take risks.
Beyond obesity treatments, major pharmaceutical firms have also been investing in CAR T cell therapy, antibody-drug conjugates, and small molecules. Recent large transactions involving Cidara Therapeutics, Verona Pharma, and Avidity Biosciences have led to higher exit values even though overall deal numbers remain low. Companies such as Verdiva Bio (focused on obesity), Kailera Therapeutics, and ReCode Therapeutics (specializing in genetic medicine) were identified as having strong exit potential for 2026.
On policy matters, while initial TrumpRx agreements have addressed some concerns about access and cost transparency—especially regarding bypassing pharmacy benefit managers—uncertainty remains over whether these models will significantly reduce out-of-pocket costs for patients.
“Despite headline price reductions, it remains uncertain whether the TrumpRx model will meaningfully lower patient out-of-pocket cost, although the benefit to pharma companies is clear as they avoid the potential for heavy import tariffs,” PitchBook commented. “At a high level, the TrumpRx initiative underscores a growing push to bypass pharmacy benefit managers and improve price transparency.”
