Novo Nordisk’s new oral version of its weight loss drug Wegovy reached more than 3,000 patients in its first week after launching in January, but challenges remain for broader patient access to obesity medications, according to a March 25 note from BMO Capital Markets following its third annual Metabolic Health Summit.
Despite strong sales—$12.5 billion for Novo Nordisk’s injectable Wegovy and $13.5 billion for Eli Lilly’s Zepbound in 2025—analysts say not all eligible patients are able to obtain these treatments due to persistent access issues. “Obesity med net pricing has declined significantly, but access remains difficult for some patients, preventing full uptake and usage among eligible patients,” BMO said.
Recent efforts by Novo Nordisk and Eli Lilly included a deal with the White House to offer their GLP-1 drugs at lower prices through President Donald Trump’s direct-to-consumer marketplace. The agreement set monthly costs at about $350 and initial doses of weight loss pills at $150. While prices have fallen over the past year, BMO noted that improvements in patient access have been limited.
BMO called the launch of oral Wegovy “impressive,” attributing early success partly to an entry cash price of $149 and brand recognition from the injectable version. Sales projections indicate that the Wegovy portfolio could rise from $13.5 billion in 2026 to $18.9 billion by 2031, with the pill accounting for an estimated $2.76 billion during that period.
Meanwhile, competition continues between Novo Nordisk and Eli Lilly as they develop next-generation therapies such as CagriSema—a combination treatment from Novo—and orforglipron from Lilly, which is under review by regulators. William Blair analysts said a key Phase 3 study (REDEFINE-11) on CagriSema is expected in early 2027 and may help investors assess its effectiveness compared with rivals.
Looking ahead, both companies are expanding research into new uses for their incretin-based therapies beyond obesity—including potential applications in addiction and depression—as well as advancing additional candidates through clinical trials.
