Prescription drug sales are projected to reach $2 trillion worldwide in 2032, with Eli Lilly’s tirzepatide brands Mounjaro and Zepbound expected to lead the market at over $70 billion in sales, according to Evaluate’s World Preview forecast released on Jun. 23. This would make these drugs the best-selling of all time, surpassing Pfizer and BioNTech’s COVID-19 vaccines.
Evaluate also projects that Foundayo, Lilly’s third major weight-loss drug, will exceed $25 billion in sales by 2032. Together, Mounjaro, Zepbound, and Foundayo are anticipated to account for nearly half of the total sales among the top ten drugs that year.
Novo Nordisk is notably absent from the top predictions despite its established presence with GLP-1 therapy semaglutide. Last year, Novo Nordisk's semaglutide brands Ozempic, Wegovy and Rybelsus generated a combined $36.19 billion in revenue compared to Mounjaro and Zepbound's combined $36.51 billion for Lilly. While Novo Nordisk has moved ahead with an oral formulation for Wegovy—approved by the FDA late last year and reaching one million patients within its first sixteen weeks—Lilly's oral challenger Foundayo was approved in April but has experienced a slower rollout.
According to Evaluate's report, “Lilly out-played one-time obesity/diabetes leader Novo Nordisk,” adding that Ozempic and Wegovy will “slip just outside the 2032 top ten best-sellers.” Both tirzepatide products are projected among the top five sellers by 2032, with Mounjaro forecasted at just over $45 billion. The report called tirzepatide the “biggest drug ever.”
Despite these projections for Lilly's dominance, Evaluate expects total semaglutide sales—including next-generation injectable CagriSema currently under FDA review—to exceed $25 billion in 2032 as well. The firm also sees continued research focus on obesity treatments; its pipeline leaderboard features several candidates targeting obesity or oncology indications.
Among these is Lilly’s triple-G agonist retatrutide—which activates GLP-1, GIP and glucagon receptors—and holds a valuation of more than $20 billion according to Evaluate. Retatrutide is being assessed across multiple Phase 3 programs for conditions such as obstructive sleep apnea and osteoarthritis.
