Eli Lilly’s obesity pill will rival Novo Nordisk’s oral Wegovy drug

Eli Lilly‘s stock is still recovering after the drugmaker released trial data earlier this month on its closely watched obesity pill that underwhelmed Wall Street.

In a key late-stage trial, Eli Lilly’s pill, orforglipron, caused less weight loss and had higher side effects than what analysts were expecting. The pill’s efficacy also appeared to come in slightly below that of Novo Nordisk‘s oral semaglutide for obesity, which showed strong data in a separate study.

Shares of Eli Lilly fell about 13% on the day the trial results were released, although they’re up about 12% since then.

But some analysts say Eli Lilly’s daily pill, if approved, could still be a viable competitor in the weight loss drug space — even if it will likely be second to enter the market. It’s a highly lucrative area that is eager for more convenient options that could ease the supply shortfalls and access hurdles created by the pricey weekly injections currently dominating it.

Analysts note that Eli Lilly’s pill could have a few advantages over the daily oral version of Novo Nordisk’s weight loss drug semaglutide, which is on track to become the first needle-free alternative for obesity to win approval in the U.S. later this year. Eli Lilly hopes to launch its pill globally “this time next year,” CEO David Ricks told CNBC in early August.

Both drugs work by mimicking a gut hormone called GLP-1 to suppress appetite and regulate blood sugar. But while Novo Nordisk’s pill is a peptide medication, orforglipron is a small-molecule drug.

That means Eli Lilly’s pill is absorbed more easily in the body and doesn’t require dietary restrictions like Novo Nordisk’s does. Orforglipron will also be easier to manufacture at scale, which is crucial as demand for obesity and diabetes injections outpaces supply.

Neither company has released prices for its respective pill, but some analysts said Eli Lilly’s drug could potentially have a lower price than Novo Nordisk’s pill. That would be a notable edge, as many health plans in the U.S. still don’t cover obesity treatments.

“It’s a little bit of an apples and oranges comparison because Novo Nordisk could have difficulty manufacturing enough of the product, given the high cost and requirements to manufacture oral semaglutide,” Leerink Partners analyst David Risinger said in an interview. 

“Whereas Lilly plans to blanket the world with orforglipron, and very quickly it will generate dramatically more sales,” he continued. “It can launch globally in an extraordinary manner with lower prices and with no food intake consideration.”

Goldman Sachs analysts seem to agree, based on a note in August. They forecast daily oral pills will capture 24% share — or around $22 billion — of the 2030 global weight loss drug market, which they expect to be worth $95 billion. 

The Goldman analysts said they expect Eli Lilly’s pill to have a 60% share — or roughly $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 around $4 billion — of that segment. The remaining 19% slice will go to other emerging pills, the analysts said.

The race to develop a more convenient obesity pill has been fraught, as companies such as Pfizer have had to scrap previous contenders and bring forward new ones. Novo Nordisk and Eli Lilly are also exploring other experimental oral drugs, along with a slate of other companies such as Viking Therapeutics, Structure Therapeutics, AstraZeneca and Roche. 

In a statement, Novo Nordisk CEO Mike Doustar said “we strongly believe in the efficacy” of the oral drug. The Danish company added it will be “laser-focused on getting this product to patients without supply constraints” in the U.S. 

Dr. Mihail “Misha” Zilbermint, director of endocrine hospitalists at Johns Hopkins Community Physicians, said it’s hard to crown a winner between Eli Lilly and Novo Nordisk without knowing how their respective pills will be priced and whether insurance will cover them. 

“I think both of the drugs are going to be gamechangers,” he said. “When it comes to which company is going to win the game — cost is the biggest issue.”

Eli Lilly’s ATTAIN-1 trial also followed 3,000 patients, while Novo Nordisk’s OASIS 4 study evaluated a much smaller group of roughly 300. There are currently no studies directly comparing the two drugs, a Novo Nordisk spokesperson said.

But Novo Nordisk’s…