Summary of Key Points
After the slowdown in the growth of GLP-1 class drugs (commonly used for weight loss) in injectable form, oral tablets have become the new focus of the market. Currently, Novo Nordisk's Wegovy oral tablet is far ahead of Eli Lilly's Foundayo in the US market: the prescription volume for Wegovy is nearly five times that of Foundayo, with a market share of 86.5% versus 13.5%. Wegovy's lead is mainly due to its better efficacy, broader insurance coverage, and higher brand recognition, while Foundayo has struggled with growth due to issues such as missed insurance approval windows and numerous drug contraindications. However, Eli Lilly is adjusting its strategy (such as investing in advertising and focusing on international markets), so the competitive landscape remains uncertain.
Market Performance: Wegovy Outperforms Foundayo by a Margin
The data clearly shows Wegovy's dominance over Foundayo:
- As of the week ending July 10, 2026, Wegovy had 153,000 prescriptions, compared to only 24,000 for Foundayo, resulting in a market share of 86.5% for Wegovy and 13.5% for Foundayo;
- Within 14 weeks of its launch, Wegovy's prescription volume exceeded 100,000 (113,000), while Foundayo had only 24,000, which is one-fifth of Wegovy's;
- In terms of growth rate, Wegovy's curve is steeper (faster growth), whereas Foundayo's growth has been stable.
This has led analysts to lower their revenue forecast for Foundayo from $5 billion to $1.2-$1.3 billion for the year, while raising their forecast for Wegovy to $2.2 billion.
Efficacy as a Key Factor: Wegovy Outperforms in Weight Loss
Efficacy is the primary factor in users' and doctors' decisions. The comparison of clinical trial data is clear:
- Wegovy tablets (25mg): an average weight loss of 13.6% after 71 weeks (compared to 15% for the injectable form);
- Foundayo (17.2mg): an average weight loss of 12% after 72 weeks (compared to 15%-20% for the injectable form).
In simple terms, taking the same oral medication, Wegovy results in a higher percentage of weight loss, which is a significant advantage for those looking to lose weight. Eli Lilly's ability to overtake Novo Nordisk in the injectable segment also highlights that "efficacy" directly determines market position.
Insurance Coverage: Eli Lilly Missed a Critical Window
In the US, most medication purchases are covered by insurance, and drugs that make it into the insurance catalog sell well.
- Starting in July 2025, CVS, the largest pharmaceutical benefits management company in the US, removed Eli Lilly's injectable Zepbound from its preferred list, retaining only Wegovy;
- Foundayo was not added to the list until July 2026, meaning that during that year, Eli Lilly's drug was less likely to be covered by insurance, and users naturally did not choose it;
- Although Foundayo now has the same level of insurance coverage as Wegovy, the missed window gave Wegovy a significant head start.
Moreover, commercial health insurance is a major source of revenue for GLP-1 weight loss drugs (the growth from out-of-pocket payments is fast but constitutes a smaller portion of total sales). Large companies already have high reimbursement rates, and these may tighten in the future, forcing pharmaceutical companies to lower prices to maintain insurance coverage.
Brand and Contraindications: Wegovy Is More Favorable Among Doctors and Users
1. Brand Recognition: Both the Wegovy tablet and injectable form share the same brand name, which is familiar to doctors and users, eliminating the need for additional promotion; in contrast, Foundayo and Eli Lilly's injectable Zepbound are different brands, and doctors (especially general practitioners) prefer to prescribe Wegovy.
2. Drug Contraindications: Although Foundayo was initially seen as more convenient (can be taken at any time of day without the need to wait half an hour before meals like with Wegovy), its contraindications have become a downside:
- It affects the effectiveness of birth control pills;
- It may interact with statin cholesterol-lowering drugs (such as simvastatin), potentially affecting their efficacy or increasing side effects.
These factors make users more inclined to choose Wegovy, as "convenience" is less important than "safety and no drug interactions."
Who Will Win in the Future? Eli Lilly Is Preparing a Counterattack
Foundayo isn't completely out of the race:
- Eli Lilly has started advertising during the NBA season to boost brand awareness;
- Eli Lilly has strong international sales capabilities, which can help make up for its shortcomings in the US market;
- It may further reduce prices to gain more insurance coverage and attract more users.
However, Wegovy's advantages, particularly in terms of efficacy and brand recognition, are currently very solid. The ultimate outcome will depend on whether Eli Lilly's strategies prove effective and whether new competitors enter the market.
Conclusion
Currently, Wegovy oral tablets are the leader in the GLP-1 oral drug market, but Eli Lilly is working to narrow the gap. For ordinary users, when choosing a medication, factors such as efficacy, insurance coverage, and potential drug interactions should be considered; for investors, it's important to monitor the strategic adjustments and market data of both companies, as pharmaceutical competition always involves a combination of "efficacy, distribution channels, and brand strength."