2026 is the yr of weight problems tablets from Novo Nordisk, Eli Lilly

The booming GLP-1 area was constructed on weekly injections. In 2026, new weight problems tablets will push the market into its subsequent chapter.

Sufferers are already getting their palms on the first GLP-1 capsule for weight problems from Danish drugmaker Novo Nordisk — a once-daily drug that shares the identical model identify as its well-liked injection Wegovy. A GLP-1 capsule from the corporate’s chief rival Eli Lilly is not far behind, with a U.S. approval anticipated inside months. 

For some folks, tablets might function a extra handy — and probably cheaper — various to right this moment’s blockbuster injections. The money costs of Novo Nordisk’s Wegovy capsule vary from $149 to $299 per thirty days, relying on the dose, which is barely lower than the newly lowered money costs of injections. 

Whereas the tablets aren’t anticipated to convey extra weight reduction than weekly pictures, based mostly on separate scientific trials, some well being specialists say increasing the vary of therapies may nonetheless be a serious win for sufferers.

Tablets may entice new sufferers to hunt weight problems remedy for the primary time, increasing the broader weight reduction and diabetes drug market and probably boosting gross sales for Novo Nordisk and Eli Lilly. The brand new customers might embody people who find themselves afraid of needles, in addition to sufferers who may benefit from present injections however do not view their situation as extreme sufficient to warrant a weekly shot.

“I feel that there are lots of people on the market who’ve by no means tried these GLP-1 medication and are perhaps ready for the tablets to return out,” stated Dr. Eduardo Grunvald, medical director of the UC San Diego Well being Heart for Superior Weight Administration. “It is sort of a pure choice for some folks and even some prescribers.” 

“Secondly, if you need to pay out of pocket, the tablets are going to be a bit cheaper than the injections, in order that’s one more reason,” he stated. 

It is unclear precisely how many individuals are presently utilizing GLP-1s within the U.S., particularly for weight problems. However round 1 in 8 adults stated they have been taking a GLP-1 drug to shed some pounds or deal with one other persistent situation as of November, in response to a ballot from well being coverage analysis group KFF.

Now, tablets are rising because the subsequent battleground for Novo Nordisk and Eli Lilly, which established the GLP-1 area that some analysts say may very well be price virtually $100 billion by the 2030s. In August, Goldman Sachs analysts forecast that tablets may seize roughly 24% — or about $22 billion — of the worldwide weight-loss drug market by 2030.

This is how weight problems tablets may reshape the area.

Oral medication might pull new sufferers into the weight problems remedy market.

“I imagine that this can fairly a bit increase the market,” Novo Nordisk CEO Mike Doustdar advised CNBC in late December. “We all know from our circle of relatives members and circles of mates that there are a lot of individuals who nonetheless wouldn’t quite take an injection … for this group of individuals, having a capsule possibility is necessary.” 

Tablets may immediate some folks to start out weight problems remedy as a result of “they suppose it is one way or the other extra acceptable or approachable” than an injection, stated Dr. Caroline Apovian, co-director of the Heart for Weight Administration and Wellness at Brigham and Ladies’s Hospital. 

That does not imply a capsule would be the greatest match for everybody. However as soon as sufferers enter the health-care system for remedy, docs can information them by way of all choices – whether or not that is an injection, metabolic surgical procedure, or structured weight loss program and train applications, Apovian stated.

UCSD’s Grunvald stated uptake of weight problems tablets is more likely to be pushed by major care physicians, who deal with the vast majority of eligible sufferers and could also be extra comfy prescribing an oral drug.

Grunvald stated weight problems medication specialists, who care for less than about 5% to 10% of eligible sufferers, usually tend to proceed favoring injections, which seem simpler than tablets based mostly on separate scientific trials.

Deborah, a 53-year-old librarian in St. Louis, Missouri, stated she is curious in regards to the new Wegovy capsule partially due to its comfort issue. She declined to offer her final identify as a consequence of considerations about stigma related to GLP-1s.

Deborah stated she would think about an oral GLP-1 as a result of she is already accustomed to taking tablets for different prescriptions. She stated an oral drug would additionally convey different advantages, like making journey simpler as a result of it will not require refrigeration, like injections do. 

She stated she can also be within the probably decrease prices of tablets. Deborah has been taking weekly injections of Wegovy since June, and was paying $449 per thirty days in money earlier than Novo Nordisk lowered that worth to $349 per thirty days. 

Price may very well be an element for different sufferers, too.

Novo Nordisk’s capsule seems to have among the many lowest money costs available in the market, at $149 per thirty days for the beginning dose and $299 per thirty days for the 2 highest doses. Eli Lilly’s rival capsule is anticipated to have comparable pricing for cash-paying sufferers. 

These customers will even be capable of entry the beginning dose of each tablets for $149 per thirty days by way of President Donald Trump‘s direct-to-consumer web site, TrumpRx, beneath a deal each corporations struck together with his administration in November. 

Weight problems injections have lengthy been onerous for sufferers to get, due partially to spotty insurance coverage protection and checklist costs of roughly $1,000 per thirty days. Each Novo Nordisk and Eli Lilly have moved to deal with these considerations by slicing money costs for his or her injectable medication to lower than half that quantity.

Eli Lilly in December stated the highest doses of single-dose vials of Zepbound will value $449 per thirty days for cash-paying sufferers, whereas Novo Nordisk in November stated practically all doses of Wegovy will value $349 per thirty days in money. 

These costs are nearer to the price of Novo Nordisk’s capsule, which can nonetheless be costly for some. However Grunvald stated the roughly $150 month-to-month distinction between the very best doses of Zepbound and Novo’s capsule “may very well be a giant distinction for many individuals” keen to pay out of pocket.

Sufferers with insurance coverage protection for Novo Nordisk’s oral drug pays as little as $25 per thirty days for the remedy. However tablets possible will not transfer the needle to spice up insurance coverage protection of GLP-1s for weight problems within the U.S. 

The direct-to-consumer money costs of Novo Nordisk’s oral drug are possible “considerably much less” than what employers and middlemen referred to as pharmacy profit managers would pay to cowl the medication, stated John Crable, senior vp of Company Synergies, an insurance coverage and worker advantages brokerage and consultancy.

Crable stated it’s unclear how a lot the capsule will finally value payers corresponding to employers since these costs should not publicly disclosed. But when they mirror injection prices — typically increased than $1,000 per thirty days — employers could also be reluctant so as to add the drug to their formularies, he stated. 

Some corporations that already provide protection of weight problems injections may add the tablets this yr. However Crable stated some employers have really dropped protection of GLP-1s for weight problems in 2026 as a consequence of their excessive prices.

“I do not see employers being extremely motivated so as to add what might be going to be one other excessive quantity, very excessive value drug to their formulary when the direct-to-consumer pricing for it’s so less expensive,” Crable stated. 

Drugmakers have tried to make a case that sufferers utilizing injections can change simply to oral medication. Eli Lilly in December launched information displaying that sufferers who initially took Wegovy or Zepbound pictures maintained the vast majority of their weight reduction after switching to the corporate’s capsule. 

However Apovian, of Brigham and Ladies’s Hospital, stated value could be the one actual cause to maneuver sufferers who’re doing nicely on injections to a capsule.

“If the [cash price] is analogous, I at all times want the injectables as a result of I imagine that the burden loss is best and the unintended effects are much less,” she stated.

Apovian stated she needs to see real-world information on how tablets carry out in contrast with injections, however separate late-stage trials already provide some clues.

Zepbound has proven common weight lack of greater than 20% in late-stage research. That is increased than outcomes seen with each the Wegovy injection and capsule in addition to Eli Lilly’s oral drug in separate trials. 

In those self same research, about 7% of sufferers or much less stopped remedy as a consequence of unintended effects from the Zepbound and Wegovy injections.

The Wegovy capsule confirmed comparable discontinuation charges, whereas about 10.3% of sufferers taking the very best dose of Eli Lilly’s oral drug stopped remedy due to unintended effects.

Leerink Companions analyst David Risinger stated sufferers with weight problems who have to lose a bigger proportion of their physique weight will possible stick to injections, except they’ve a worry of needles.

Tablets, he stated, may primarily entice new sufferers who’re chubby or mildly overweight and need to obtain solely “modest” weight reduction.

Some sufferers presently utilizing weekly injections might strive tablets, Risinger added, although not all will discover a day by day oral possibility extra handy.

That features Karen Galante, 42, of Horsham, Pennsylvania, who’s taking a compounded model of semaglutide – the lively ingredient in Wegovy – which she stated is priced equally to Novo Nordisk’s new capsule.

Galante stated she doesn’t plan to change.

“It is onerous sufficient for me to recollect to take my nutritional vitamins every single day,” she stated. “I just like the set-it-and-forget-it of taking one shot every week.” 

Risinger stated he expects each tablets from Novo Nordisk and Eli Lilly to “take off like a rocket” this yr. 

He famous that uptake can be better for the Wegovy capsule initially since Eli Lilly’s drug, orforglipron, is probably going nonetheless months away from coming into the market.

However Risinger stated he believes Eli Lilly’s capsule will finally generate increased gross sales as a result of sufferers may think about it extra handy.

Eli Lilly’s orforglipron is a small-molecule drug that’s absorbed extra simply within the physique and would not require dietary restrictions like Novo Nordisk’s capsule, which is a peptide medicine. Sufferers are alleged to drink not more than 4 ounces of water with the Wegovy capsule and should wait half-hour earlier than consuming or ingesting anything every day. 

However Novo Nordisk’s CEO Doustdar has argued that these dietary necessities will not hinder uptake. He advised CNBC in December it has not been a difficulty for the greater than 1,000,000 people who find themselves taking the lower-dose model of the capsule for diabetes, marketed as Rybelsus, which entered the market in 2019. 

“Merely sip and go, and you are going to be high quality,” Doustdar stated. “These persons are waking up within the morning and taking their capsule with a glass of water, after which they do their regular day by day routine half an hour later and transfer on with their life.”

He additionally referred to as the corporate’s drug the “most efficacious capsule,” saying that no different merchandise in growth have been in a position to present its identical degree of weight reduction in a late-stage trial. 

The best dose of Novo Nordisk’s Wegovy capsule helped sufferers lose as much as 16.6% of their weight on common at 64 weeks in a single late-stage examine. That is akin to the injectable type of the drug. 

There are not any head-to-head research immediately evaluating that capsule with Eli Lilly’s. In considered one of Eli Lilly’s late-stage trials, the very best dose of its capsule helped sufferers lose 12.4% of their physique weight on common at 72 weeks. 

Regardless of that distinction in efficacy, Risinger stated the 2 tablets are seen as selling roughly comparable ranges of weight reduction. Some sufferers can also not have to take the very best dose of both capsule, he added. 

In an August be aware, Goldman analysts stated they count on Eli Lilly’s capsule to have a 60% share — or roughly $13.6 billion — of the day by day oral section of the market in 2030. They count on Novo Nordisk’s oral semaglutide to have a 21% share — or round $4 billion — of that section. The analysts stated they count on the remaining 19% slice to go to different rising tablets.

Different drugmakers are racing to convey their very own oral choices to the market, together with Pfizer, AstraZeneca, Construction Therapeutics and Viking Therapeutics. 

Risinger highlighted Construction’s day by day oral GLP-1, which is able to enter part three trials later this yr. Shares of Construction soared greater than 100% on Dec. 9 after it launched midstage information displaying that its capsule, aleniglipron, helped sufferers with weight problems lose greater than 11% of their weight at 36 weeks, when adjusted for placebo. 

Extra trial information confirmed {that a} increased dose of the capsule may ship better efficacy – greater than 15% weight reduction – surpassing the outcomes seen with the very best dose of Eli Lilly’s orforglipron. Nonetheless, the tolerability information, or how nicely sufferers tolerated Construction’s remedy, gave the impression to be worse than that of Eli Lilly’s capsule. 

In a launch on the time, Construction CEO Raymond Stevens stated the capsule may very well be “probably best-in-class” for an oral small-molecule GLP-1. 

Risinger stated he expects that capsule and one other oral GLP-1 from AstraZeneca may launch as quickly as late 2028. 

He stated potential tablets which are taken weekly, versus day by day, and have “compelling profiles may tilt the steadiness extra in the direction of orals” available in the market. 

Risinger pointed to privately held Verdiva Bio, which is growing a number of oral peptide therapies designed to be taken as soon as every week. That firm has an ongoing part two trial on an oral GLP-1.