2026 is the year of obesity pills from Novo Nordisk, Eli Lilly

The booming GLP-1 space was built on weekly injections. In 2026, new obesity pills will push the market into its next chapter.

Patients are already getting their hands on the first GLP-1 pill for obesity from Danish drugmaker Novo Nordisk — a once-daily drug that shares the same brand name as its popular injection Wegovy. A GLP-1 pill from the company’s chief rival Eli Lilly isn’t far behind, with a U.S. approval expected within months. 

For some people, pills may serve as a more convenient — and potentially cheaper — alternative to today’s blockbuster injections. The cash prices of Novo Nordisk’s Wegovy pill range from $149 to $299 per month, depending on the dose, which is slightly less than the newly lowered cash prices of injections. 

While the pills aren’t expected to bring more weight loss than weekly shots, based on separate clinical trials, some health experts say expanding the range of treatments could still be a major win for patients.

Pills could attract new patients to seek obesity treatment for the first time, expanding the broader weight loss and diabetes drug market and potentially boosting sales for Novo Nordisk and Eli Lilly. The new users may include people who are afraid of needles, as well as patients who could benefit from existing injections but don’t view their condition as severe enough to warrant a weekly shot.

“I think that there are a lot of people out there who have never tried these GLP-1 drugs and are maybe waiting for the pills to come out,” said Dr. Eduardo Grunvald, medical director of the UC San Diego Health Center for Advanced Weight Management. “It’s kind of a natural preference for some people and even some prescribers.” 

“Secondly, if you have to pay out of pocket, the pills are going to be a bit less expensive than the injections, so that’s another reason,” he said. 

It’s unclear exactly how many people are currently using GLP-1s in the U.S., especially for obesity. But around 1 in 8 adults said they were taking a GLP-1 drug to lose weight or treat another chronic condition as of November, according to a poll from health policy research organization KFF.

Now, pills are emerging as the next battleground for Novo Nordisk and Eli Lilly, which established the GLP-1 space that some analysts say could be worth almost $100 billion by the 2030s. In August, Goldman Sachs analysts forecast that pills could capture roughly 24% — or about $22 billion — of the global weight-loss drug market by 2030.

Here’s how obesity pills could reshape the space.

Oral drugs may pull new patients into the obesity treatment market.

“I believe that this will quite a bit expand the market,” Novo Nordisk CEO Mike Doustdar told CNBC in late December. “We know from our own family members and circles of friends that there are many people who still would not rather take an injection … for this group of people, having a pill option is important.” 

Pills could prompt some people to start obesity treatment because “they think it’s somehow more acceptable or approachable” than an injection, said Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital. 

That doesn’t mean a pill will be the best fit for everyone. But once patients enter the health-care system for treatment, doctors can guide them through all options – whether that’s an injection, metabolic surgery, or structured diet and exercise programs, Apovian said.

UCSD’s Grunvald said uptake of obesity pills is likely to be driven by primary care physicians, who treat the majority of eligible patients and may be more comfortable prescribing an oral drug.

Grunvald said obesity medicine specialists, who care for only about 5% to 10% of eligible patients, are more likely to continue favoring injections, which appear more effective than pills based on separate clinical trials.

Deborah, a 53-year-old librarian in St. Louis, Missouri, said she is curious about the new Wegovy pill in part because of its convenience factor. She declined to provide her last name due to concerns about stigma associated with GLP-1s.

Deborah said she would consider an oral GLP-1 because she is already accustomed to taking pills for other prescriptions. She said an oral drug would also bring other benefits, like making travel easier because it won’t require refrigeration, like injections do. 

She said she is also interested in the potentially lower costs of pills. Deborah has been taking weekly injections of Wegovy since June, and was paying $449 per month in cash before Novo Nordisk lowered that price to $349 per…