Novo, Lilly are preparing for oral GLP-1s to be the next big thing in obesity

After competing against one another in the injectable GLP-1 space for the past few years, Novo Nordisk and Eli Lilly are now moving their fight to the oral stage. While the Danish drugmaker has a leg up on the launch of its oral obesity offering, both drugmakers on Thursday disclosed investments aimed at streamlining the global rollout of their respective products. 

Following the January launch of Novo's oral Wegovy (semaglutide) in the US, the pill is already off to the races, posting impressive uptake numbers in its first month on the market (see Spotlight On: Novo Nordisk's Wegovy pill trades margin for momentum). According to a recent FirstWord poll, needle-averse patients have been drawn in by an oral option (see – Physician Views Results: Rapid Wegovy pill uptake driven by oral preference and injection aversion).

And though the Wegovy pill may have had a headstart, UBS's Michael Yee is modelling just $800 million in 2026 sales for the weight-loss drug — and predicting that its upcoming competitor, Lilly's orforglipron, will bring in $2 billion after its anticipated second-quarter launch (see – Vital Signs: Pharma's growth drivers and growing pains for 2026).

Novo's Ireland-fueled international push

After calling out pricing headwinds in the US — and facing continued pressure from compounders — Novo Nordisk seems to be turning its focus to international markets. 

According to a report from Bloomberg, the company is expanding the capacity of a facility in Athlone, Ireland, so it can make the Wegovy pill for markets outside the US, CEO Mike Doustdar said. 

The announcement comes about a week after the Danish drugmaker revealed underwhelming sales guidance for its obesity portfolio, projecting that total revenues would drop between 5% and 13% in 2026, amidst increasing competition from Lilly (see – Vital Signs: Eli Lilly takes no prisoners in obesity battle).

“If we were about to throw in the towel, we would not be investing in factories in Ireland,” Doustdar told Bloomberg.

Novo Nordisk paid $92.5 million in 2024 to buy the Athlone facility from Alkermes as it ramped up manufacturing to meet demand for injectable semaglutide, marketed as Wegovy for obesity and Ozempic for type 2 diabetes. Last year, the pharma said it will eliminate about 75 positions from the Ireland site as part of broader efforts to cut 9000 staffers worldwide. 

Lilly's oral stockpile 

For its part, Lilly revealed in a Thursday securities filing that it has spent $1.5 billion to build up its supply of orforglipron ahead of its expected FDA approval in April. 

According to earlier remarks from the drugmaker, it should have enough of its weight-loss pill to launch in several countries nearly simultaneously.  

During Lilly's presentation at the JP Morgan Healthcare Conference in January, CEO Dave Ricks touted the company's international aspirations with an oral obesity option. It's planning to replicate its US cash-pay success with orforglipron in massive middle-income countries like India, Indonesia, China and Brazil it couldn't reach previously with its injectable weight-loss treatments due to refrigeration constraints (see – JPM26: Novo Nordisk, Eli Lilly trade blows on oral obesity aspirations).