The GLP-1 space is evolving in 2026 with the introduction of new obesity pills from Novo Nordisk and Eli Lilly, offering a more convenient and potentially cheaper alternative to weekly injections. Novo Nordisk’s Wegovy pill ranges from $149 to $299 per month, slightly less than injections. Pills may attract new patients and reshape the weight loss and diabetes drug market. Pills are expected to capture about 24% of the global weight-loss drug market by 2030, potentially worth $22 billion. Novo Nordisk CEO believes pills will expand the obesity treatment market by attracting patients who prefer oral drugs over injections. Some patients may find pills more acceptable and approachable, prompting them to seek treatment. Primary care physicians are likely to drive uptake of obesity pills, while obesity medicine specialists may continue favoring injections due to perceived effectiveness. Cost could be a factor for patients, as Novo Nordisk’s pill has cash prices starting at $149 per month, with similar pricing expected for Eli Lilly’s pill. Patients can also access the starting dose of both pills for $149 per month through TrumpRx. Novo Nordisk and Eli Lilly have lowered cash prices for their injectable drugs to address affordability concerns. Eli Lilly set the price of Zepbound single-dose vials at $449/month for cash-paying patients, while Novo Nordisk priced Wegovy at $349/month. The cost may still be high for some, but the $150 difference between Zepbound and Novo’s pill could be significant for many willing to pay out of pocket.

Insurance can bring the cost of Novo Nordisk’s oral drug down to $25/month, but this likely won’t increase insurance coverage for obesity treatments in the US. Cash prices are lower than what employers and pharmacy benefit managers pay, potentially affecting formulary decisions.

Employers may be hesitant to add the new pills to their formularies if costs mirror injections, which can be over $1,000/month. Some companies may add pill coverage in 2026, but others dropped GLP-1 coverage due to high costs. Employers may not be motivated to add costly drugs with cheaper direct-to-consumer prices.

Eli Lilly released data showing patients who switched from injections to their pill maintained weight loss. Cost would be the main reason for the switch, but some prefer injections for better weight loss and fewer side effects. Zepbound showed over 20% weight loss, with low side effect discontinuation rates compared to Wegovy and Eli Lilly’s pill.

Analysts believe patients needing significant weight loss may stick with injections, while new patients or those seeking modest weight loss may prefer pills. Some current injection users may switch, but not all may find daily pills more convenient. Patients like Karen Galante may stick with injections for convenience.

Analysts predict Novo Nordisk and Eli Lilly’s pills will be successful, with Wegovy expected to have higher initial uptake due to earlier market entry. Lilly’s orforglipron may generate more sales long-term due to perceived convenience. Novo Nordisk’s pill has dietary restrictions, while Lilly’s is more easily absorbed and doesn’t require restrictions.

Novo Nordisk’s CEO believes dietary requirements won’t hinder pill uptake, touting the convenience of the drug. The highest dose of Wegovy helped patients lose up to 16.6% of their weight, similar to the injectable form. Though efficacy differs, both pills are seen as promoting similar weight loss levels. Eli Lilly’s pill is projected to claim a 60% market share worth $13.6 billion in the daily oral segment by 2030. Novo Nordisk’s oral semaglutide is expected to secure a 21% share valued at around $4 billion. Other emerging pills are anticipated to take up the remaining 19% of the market.

Structure Therapeutics’ daily oral GLP-1, aleniglipron, demonstrated promising results in midstage trials, leading to more than 11% weight loss in patients with obesity after 36 weeks. The pill could potentially achieve over 15% weight loss with a higher dose, outperforming Eli Lilly’s pill but showing worse tolerability data.

Structure CEO Raymond Stevens believes their pill could be a top contender in the oral small-molecule GLP-1 market. The company is set to launch the pill alongside AstraZeneca’s oral GLP-1 as early as late 2028. Weekly oral peptide treatments from Verdiva Bio could also shift the market towards oral options, with ongoing phase two trials on an oral GLP-1.

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