GLP-1-based medicines have become one of the most commercially important areas in pharmaceutical development, with companies competing on weight-loss efficacy, oral delivery, cardiovascular benefits, dosing convenience and next-generation multi-agonist therapies.
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Two companies currently dominate the commercial landscape: Novo Nordisk and Eli Lilly. However, Amgen, Pfizer, Roche and several emerging biopharma companies are investing heavily in next-generation obesity treatments.
1. Novo Nordisk – Wegovy and Next-Generation GLP-1 Innovation
Novo Nordisk remains one of the most established obesity-focused manufacturers, with Wegovy (semaglutide) as its flagship weight-management therapy.
In 2025, Novo Nordisk’s obesity-care sales reached DKK 82.35 billion, increasing 26% in reported currency and 31% at constant exchange rates. The company reported that global branded GLP-1 obesity volume increased 104%, while Novo held a 59.6% branded volume share.
Novo’s 2025 annual report also reported that its obesity portfolio reached 3.6 million people globally and that Wegovy was available in 52 countries.
Key innovation
Novo is expanding beyond injectable semaglutide.
Its next-generation obesity portfolio includes:
- Wegovy 7.2 mg, which demonstrated 20.7% weight loss in Phase 3 studies.
- Oral Wegovy, with reported weight loss of 16.6% and once-daily dosing.
- CagriSema, a combination of semaglutide and cagrilintide.
- Additional pipeline programs targeting obesity and related metabolic diseases.
The oral Wegovy strategy is particularly important because it could expand GLP-1 treatment among patients who prefer tablets over injections.
Pros
- Largest established obesity-focused commercial franchise
- Extensive semaglutide clinical experience
- Strong global manufacturing infrastructure
- Expanding oral and higher-dose formulations
- Broad international presence
Cons
- Increasing competition from Eli Lilly
- Heavy dependence on the semaglutide franchise
- Manufacturing and pricing pressure remain important challenges
- Next-generation pipeline results have created uncertainty around future growth
2. Eli Lilly – Zepbound, Mounjaro and Next-Generation Obesity Drugs
Eli Lilly has become Novo Nordisk’s strongest competitor through tirzepatide, a dual GIP/GLP-1 receptor agonist marketed as Zepbound for obesity and Mounjaro for type 2 diabetes.
Lilly reported $65.18 billion in total revenue in 2025, up 45% from 2024.
Mounjaro generated $22.97 billion, while Zepbound generated $13.54 billion in 2025.
Together, Mounjaro and Zepbound accounted for 56% of Lilly’s total 2025 revenue, demonstrating how important incretin medicines have become to the company.
The momentum continued in 2026. In Q2 2026, Mounjaro sales increased 91% to $9.94 billion, while Zepbound generated $4.93 billion. Lilly subsequently raised its 2026 revenue forecast to $85–$87 billion.
Key innovation
Lilly is moving beyond injectable tirzepatide with:
- Orforglipron (Foundayo) — an oral GLP-1 medicine
- Retatrutide — a next-generation triple agonist targeting GIP, GLP-1 and glucagon
- Additional obesity and cardiometabolic programs
Lilly’s strategy is therefore built around higher efficacy + oral convenience + broader metabolic benefits.
Pros
- Very strong commercial performance
- Dual GIP/GLP-1 mechanism
- Major investment in manufacturing capacity
- Oral GLP-1 development
- Next-generation triple-agonist pipeline
- Expanding cardiovascular and metabolic indications
Cons
- High manufacturing requirements
- Significant pricing and reimbursement pressure
- Strong dependence on Mounjaro/Zepbound
- Increasing competition from Novo and emerging obesity developers
3. Amgen – MariTide and Long-Acting Obesity Innovation
Amgen is pursuing a different approach with MariTide (maridebart cafraglutide), an investigational molecule designed to target both GLP-1 and GIP pathways.
Its major potential differentiator is less frequent dosing compared with conventional weekly injectable therapies.
The program is being closely watched because monthly or less-frequent administration could potentially address one of the biggest challenges in obesity treatment: long-term treatment persistence and convenience.
Why Amgen matters
The company brings substantial experience in:
- Biologics manufacturing
- Metabolic disease development
- Large-scale commercial production
- Specialty medicines
Pros
- Potentially less-frequent dosing
- Strong biologics manufacturing experience
- Major pharmaceutical development capabilities
- Potential differentiation beyond weekly GLP-1 therapy
Cons
- MariTide remains investigational
- Long-term safety and efficacy evidence is still developing
- Commercial positioning will depend heavily on comparative trial results
4. Pfizer – Oral GLP-1 and Obesity Pipeline
Pfizer remains an important pharmaceutical company to watch because of its efforts to develop oral obesity medicines.
The company has been evaluating small-molecule approaches intended to provide GLP-1 activity without requiring injections.
This strategy is important because the obesity category is increasingly moving toward tablet-based treatment, which could potentially simplify administration and expand access.
Pros
- Strong global pharmaceutical infrastructure
- Significant small-molecule development expertise
- Oral-treatment strategy
- Large commercial and manufacturing network
Cons
- Several obesity programs have faced clinical-development setbacks
- Competition from Novo and Lilly is intense
- Oral GLP-1 efficacy and tolerability must compete against established injectable products
5. Roche – Next-Generation Obesity Pipeline
Roche has entered the obesity race through its acquisition of Carmot Therapeutics, gaining access to a portfolio of incretin-based medicines.
Its pipeline includes CT-996, an oral GLP-1 receptor agonist, alongside other metabolic programs.
Roche’s broader strategy is focused on developing obesity treatments that could potentially provide substantial weight reduction while addressing metabolic complications.
Pros
- Major global pharmaceutical R&D infrastructure
- Strong metabolic-disease ambitions
- Oral GLP-1 development
- Multiple potential approaches to obesity treatment
Cons
- Portfolio remains earlier-stage than Novo and Lilly’s commercial franchises
- Clinical differentiation still needs to be demonstrated
- Commercial opportunity depends on successful late-stage development
Top Manufacturers Compared
| Company | Leading obesity product/pipeline | Mechanism | Delivery | 2025/2026 commercial signal | Main innovation |
|---|---|---|---|---|---|
| Novo Nordisk | Wegovy, oral Wegovy, CagriSema | GLP-1 / combination | Injectable + oral | DKK 82.35B obesity sales in 2025 | High-dose + oral GLP-1 |
| Eli Lilly | Zepbound, Mounjaro, Foundayo, retatrutide | GIP/GLP-1 / triple agonist | Injectable + oral | $36.51B Mounjaro + Zepbound sales in 2025 | Dual and triple agonism |
| Amgen | MariTide | GIP/GLP-1 | Injectable | Investigational | Less-frequent dosing |
| Pfizer | Oral GLP-1 programs | GLP-1 | Oral | Development-stage | Oral small molecules |
| Roche | CT-996 and related programs | GLP-1 / metabolic targets | Oral + other approaches | Development-stage | Next-generation metabolic medicines |
The Numbers Behind the Competition
| Metric | Novo Nordisk | Eli Lilly |
|---|---|---|
| 2025 obesity-care/product sales | DKK 82.35B | – |
| 2025 Mounjaro sales | – | $22.97B |
| 2025 Zepbound sales | – | $13.54B |
| Combined Mounjaro + Zepbound | – | $36.51B |
| 2025 obesity-care growth | +26% reported / +31% CER | – |
| 2025 global branded GLP-1 obesity volume growth | +104% | – |
| Novo branded volume share | 59.6% | – |
| Lilly 2025 total revenue | – | $65.18B |
| Mounjaro + Zepbound share of Lilly revenue | – | 56% |
Sources: Novo Nordisk 2025 Annual Report and Eli Lilly 2025 SEC filing.
What Is Driving the Next Wave of GLP-1 Innovation?
The competitive focus is shifting beyond simply producing another weekly injection.
Companies are investing in:
- Oral GLP-1 medicines
- Higher-dose formulations
- Dual GIP/GLP-1 agonists
- Triple agonists
- Longer-acting treatments
- Cardiovascular-risk reduction
- Metabolic-disease combinations
- Liver-disease applications
- Muscle-preservation strategies
- More convenient administration
The oral category is particularly competitive. Novo’s oral Wegovy and Lilly’s Foundayo are now creating a new battleground around convenience, efficacy, pricing and patient access.
Why Manufacturing Is Becoming a Competitive Advantage
GLP-1 demand has created an unusual pharmaceutical challenge: clinical success must be matched by manufacturing scale.
Manufacturers need capacity for:
- Active pharmaceutical ingredients
- Peptide production
- Formulation
- Sterile filling
- Injection devices
- Tablets for oral products
- Packaging
- Cold-chain distribution
Lilly has already undertaken major manufacturing expansion initiatives to support current and future demand.
The scale of demand is also attracting counterfeit and unauthorized products. In the UK, regulators have seized nearly 90,000 illegal weight-loss injections since 2023, highlighting the pressure created by strong consumer demand and unequal access.
Who Is Buying These Therapies?
The major stakeholders influencing GLP-1 adoption include:
Patients and consumers — seeking effective and convenient weight management.
Physicians — including endocrinologists, obesity specialists and primary-care providers.
Health insurers and government payers — evaluating clinical outcomes versus treatment costs.
Employers — increasingly reassessing coverage as obesity-drug spending rises.
Pharmacies and specialty pharmacies — handling dispensing and patient support.
Healthcare systems — managing obesity-related complications and long-term treatment.
In the U.S., employer coverage is becoming an important pressure point. A 2026 survey reported that 14% of employers had already dropped or planned to drop coverage for GLP-1 drugs for weight loss by 2027, while projected healthcare-cost growth reached 9.2% for 2027.
The Strategic Takeaway
The GLP-1 race is no longer simply Novo Nordisk vs. Eli Lilly.
It is evolving into competition around:
Efficacy + oral delivery + dosing frequency + manufacturing scale + cardiovascular outcomes + affordability + long-term adherence.
Novo Nordisk currently has enormous obesity-care scale, with DKK 82.35 billion in 2025 obesity sales and 59.6% branded volume share. Eli Lilly, however, has built extraordinary momentum through Mounjaro and Zepbound, which generated $36.51 billion combined revenue in 2025.
Meanwhile, Amgen, Pfizer and Roche are attempting to differentiate through longer-acting, oral and next-generation metabolic therapies.
For pharma and biotech leaders, the key question is no longer simply:
“Who has the best GLP-1 drug?”
It is:
“Which company can combine clinical efficacy, manufacturing scale, patient convenience and long-term metabolic outcomes into the strongest obesity-treatment platform?”
Towards Healthcare Research & Consulting can help track GLP-1 pipelines, clinical trials, company revenues, manufacturing investments, drug launches, competitor strategies, obesity populations, pricing, reimbursement and patient demand across global markets.
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