How Many People Take GLP-1 Drugs in the US? The Numbers by Quarter
About 11 million unique US patients were on a GLP-1 as of Q2 2025, and the class passed 9 million prescriptions a month by end of 2024. Here is how Wegovy, Zepbound, the Wegovy pill and Foundayo split the market since.
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About 11 million unique patients in the US were taking a GLP-1 drug as of the second quarter of 2025, counting all indications together — diabetes and obesity [1]. The class had been running at about 2.5 million prescriptions per month before October 2022, more than doubled within a year, and passed 9 million prescriptions per month by the end of 2024 [1]. Two oral launches in 2026 — Novo Nordisk’s Wegovy pill in January and Lilly’s Foundayo in April — have added volume on top of that base, with the Wegovy pill passing 5 million total prescriptions since launch by August 2026 [5].
On market split, Lilly’s tirzepatide medicines hold roughly 60% of US obesity prescriptions and Novo Nordisk’s semaglutide medicines roughly 40%, a split that stayed stable through August 2026 [7]. Zepbound leads the weekly prescription totals among obesity drugs, while Novo says the Wegovy franchise leads on new patient starts [5][7].
How many Americans are on a GLP-1 drug?
The most recent patient count from IQVIA is 11 million unique US patients using a GLP-1 across indications, as of the second quarter of 2025, after consistent year-over-year growth [1]. Before 2022, the treated population was much smaller: only 1.8% of patients diagnosed with obesity — about 1.6 million people — had started any anti-obesity treatment [1].
Prescription volume tells a similar story from a different angle. In the commercial channel, GLP-1 prescriptions grew from 680,000 in January 2020 to 4.7 million in May 2025; Medicare prescriptions rose from 400,000 to 2 million over the same period [2]. Those are prescription counts, not patient counts, and they cover the whole class including diabetes use.
How fast did GLP-1 prescriptions grow before the pills?
Before October 2022, the GLP-1 class was filling about 2.5 million prescriptions per month in the US [1]. Volume more than doubled within a year, and by the end of 2024 the class had surpassed 9 million prescriptions per month [1]. These are monthly, class-wide numbers that include diabetes prescriptions, not weekly obesity-only counts.
Part of the speed came from prescriber breadth. At 12 months post-launch, Mounjaro and Zepbound had amassed four times as many unique prescribers as the earlier launches of Ozempic and Wegovy [1]. In the commercial market, new-to-brand GLP-1 prescriptions rose more than 700% over four years [10].
What changed in 2026: two oral GLP-1 launches
The FDA approved the Wegovy pill (oral semaglutide 25 mg) on December 22, 2025, and Novo Nordisk launched it in the US on January 5, 2026 [12][3][5]. The starting dose carries a self-pay price of $149 per month, and self-pay prices range from $149 to $299 per month depending on dose [12][5].
The FDA approved Foundayo (orforglipron) on April 1, 2026 [13]. Lilly accepted prescriptions on LillyDirect immediately, began shipping on April 6, and opened broad availability through US retail pharmacies and telehealth providers on April 9 [13][3]. Self-pay pricing starts at $149 per month for the lowest dose, eligible people with commercial coverage may pay as little as $25 per month with a savings card, and eligible Medicare Part D individuals may get it for $50 per month beginning July 1, 2026 [13].
How many Wegovy pill prescriptions have there been?
The Wegovy pill recorded 3,071 prescriptions in its first four days after the January 5 launch, and 18,410 through its second week [3][7]. Novo Nordisk reported about 1.3 million prescriptions in the first quarter of 2026, about 2.9 million in the second quarter, and more than 5 million since launch as of its August 2026 report [4][5]. Novo calls this the strongest-ever GLP-1 volume launch in the US — that is the company’s own characterization [5].
IQVIA’s early read on the launch: within eight weeks, the pill had captured roughly one-third of new-to-brand obesity prescriptions, about two-thirds of its users were new to any GLP-1 therapy, and the majority of volume flowed through cash-pay channels [6].
Weekly totals climbed through the summer. One caution applies to every number in the table below: these are IQVIA data as cited by Citi or Jefferies in Fierce Pharma’s tracker, not primary IQVIA publications, and no single week should be treated as definitive [7]. Each row takes both figures from a single Fierce Pharma update [7].
| Fierce Pharma update (2026) | Wegovy pill TRx | Foundayo TRx |
|---|---|---|
| July 17 (week after July 4 holiday) | 147,500 | 24,303 |
| July 24 | 169,800 | 26,760 |
| July 31 | ~171,700 | 29,388 |
| August 7 | ~172,000 | 34,219 |
| August 14 | ~163,000 | 38,928 |
| August 21 | ~176,000 | 36,620 |
| August 28 (Foundayo week 20) | ~175,000 | 40,862 |
| September 11 | ~183,000 | 47,500 |
All figures from IQVIA data cited by Citi or Jefferies [7].
How is Foundayo selling?
Foundayo recorded 1,390 prescriptions in the week ending April 10 — likely reflecting only about two days of data capture — and 3,707 through its second week [3][7]. For first-week context, injectable Zepbound recorded 1,100 prescriptions in its launch week and injectable Wegovy 768 [7].
Foundayo then sat flat near 20,000 prescriptions per week for five weeks into early July, peaking at 21,648 in week 10 and falling to 19,550 in week 13 [7]. From the week after July 4 onward it climbed: 24,303, then 26,760, 29,388, 34,219, 38,928, a dip to 36,620, 40,862 in week 20, roughly 44,000, and 47,500 in the September 11 update [7].
Analysts and the company both urged patience with the early numbers. RBC said weeks 8 to 12 were the earliest window to judge Foundayo’s commercial momentum [3]. Lilly CEO David Ricks said the ramp would take “quarters, not days” [4]. Jefferies noted CVS was the last of the big three pharmacy benefit managers to cover Foundayo, starting June 1 [7].
Revenue in Foundayo’s first quarter on the market was $98 million worldwide, including $67 million in the US [9][7]. Jefferies had modeled $71 million in US sales — a forecast, not a result — against a Wall Street consensus of $130 million [7].
Who has more prescriptions: Zepbound or Wegovy?
Zepbound leads on weekly totals. In the week after the July 4 holiday, Zepbound recorded just under 660,000 total prescriptions and the Wegovy franchise about 448,500, in a week when the total GLP-1 market fell 5.1% week over week [7]. By early September, Zepbound was near 772,000 and total Wegovy near 513,500 [7].
Novo’s own figures for the week ending July 17 put total Wegovy prescriptions at around 575,000 — more than 265,000 for the pill and around 310,000 for the injectable, of which about 120,000 were filled in the self-pay channel [5]. That 120,000 of 310,000 works out to roughly 39% self-pay, a share derived from Novo’s figures rather than stated by the company [5].
Across the obesity market, the split held at roughly 60% Lilly to 40% Novo through August 2026, measured at 60.1% to 39.9% in mid-August [7]. Measured by new patient starts, Novo says the Wegovy franchise remained the market leader among branded obesity medications in the US in Q2 2026 [5], and CEO Mike Doustdar said in Q1 2026 that Wegovy had 65% of all new US prescriptions [4].
Across the total GLP-1 market — obesity plus diabetes — Lilly’s tirzepatide held nearly 57% as of September 2026, up from around 49.5% a year earlier, while Novo’s semaglutide stayed relatively flat at about 37% [7].
Why do the prescription numbers disagree between sources?
Mostly because of data capture. Novo Nordisk says external data providers are still expected to gradually improve their capture rate of Wegovy pill prescriptions across channels in coming quarters [5]. Lilly cautioned that early weekly figures would not be fully comprehensive and are “best interpreted over time rather than as a complete count” [3].
Citi analysts emphasized that IQVIA may still be missing some Foundayo prescriptions made through telehealth channels, and that it is not clear how much of the drug’s apparent growth reflects IQVIA getting better at including those data [7]. Jefferies cautioned that initial IQVIA capture rates are “volatile” and may not include product sampling [7].
Channel breadth is part of the problem: the Wegovy pill is sold through more than 70,000 pharmacies, including NovoCare Pharmacy, and nine telehealth organizations [5].
What did Lilly report for Q2 2026?
Lilly’s Q2 2026 revenue was $22,974 million, up 48% from $15,558 million a year earlier [9]. Worldwide, volume grew 60% while realized prices fell 13% — and those two figures cover all Lilly products, not just GLP-1s [9].
| Product | Q2 2026 | Q2 2025 | Change |
|---|---|---|---|
| Mounjaro | $9,943M | $5,199M | +91% |
| Zepbound | $4,928M | $3,381M | +46% |
| Foundayo | $98M | — | first quarter on market |
All figures from Lilly’s Q2 2026 report [9].
Mounjaro’s US revenue was $4.8 billion, up 45%, and revenue outside the US rose 172% to $5.2 billion, driven by volume and affected by Mounjaro’s addition to China’s National Reimbursement Drug List [9]. The Zepbound line covers the US, Canada and Japan; US Zepbound revenue was $4.9 billion, up 44%, with lower realized prices — including previously announced cash-pay price cuts — partly offsetting demand [9].
Total US revenue grew 33% on volume up 37% and realized prices down 3%, or about 9% excluding adjustments to rebate and discount estimates [9]. For the first half of 2026, Mounjaro revenue was $18,605 million, up 106%, and Zepbound $9,088 million, up 60% [9].
What did Novo Nordisk report for Q2 2026?
Novo’s Q2 2026 net sales were DKK 78,488 million, up 3% at constant exchange rates as reported and up 7% adjusted [5]. Obesity care sales were DKK 23,152 million, up 16% adjusted [5].
By brand, Wegovy injectable sales were DKK 19,484 million, up 1% at CER, and Wegovy pill sales were DKK 3,218 million, of which DKK 3,141 million came from the US [5]. In Q1 2026, the pill’s first quarter on the market, sales of DKK 2.26 billion came in well above analyst estimates of DKK 1.16 billion [4]. US sales of Wegovy injectable fell 22% at CER in Q2 2026, driven by lower realized prices and partly offset by volume [5].
One accounting item explains most of the gap between reported and adjusted growth. Novo recorded 340B Drug Pricing Program rebate provision reversals of DKK 26.8 billion in Q1 2026 and DKK 2.6 billion in Q2 2025, with none in Q2 2026; the reversals have no cash impact [5]. That is why H1 2026 sales grew 18% at CER as reported but only 2% adjusted [5].
Who writes GLP-1 prescriptions?
Endocrinologists and internists still dominate, but their share of GLP-1 prescribing fell from 93% in 2020 to 83% in 2025 [10]. In 2025, prescribing by those specialists grew 500%, while prescribing by non-diabetes specialists grew 900% — though non-diabetes specialists still account for less than 20% of overall GLP-1 volume [10].
Is the GLP-1 market still growing in 2026?
Yes, by prescription count. Citi’s September 2026 read of IQVIA data showed total GLP-1 prescriptions up 5.4% over the prior four weeks, compared with a 6.8% decline in the same measure a year earlier — a swing the analysts attributed to oral GLP-1s broadening access and drawing in new patients [7].
But volume growth is arriving alongside sharp price declines. After the launches of Wegovy in 2021 and Zepbound in 2023, the drugs retailed for about $1,000 per month in pharmacies; they now sell on company websites for starting prices of $149 to $299 [11]. Forecasters have cut their 2030 obesity market estimates by about 30% to roughly $100 billion, with the $150 billion figure pushed to 2035 for some [11]. Goldman Sachs lowered its 2030 estimate to $105 billion from $130 billion, Jefferies now sees a peak of $80 billion, and IQVIA pushed its roughly $130 billion forecast out to 2034 from 2028 [11].
IQVIA’s ForecastLink puts the global obesity medicines market at $66 billion in list-price sales value in 2025, forecast to reach $92 billion in 2026 [6]. Those are list-price values, not net sales, so they cannot be compared directly with company revenue figures.
How to read future prescription and sales headlines
A few distinctions matter. TRx means total prescriptions, including refills; NRx means new prescriptions, excluding refills; and new patient starts is a separate measure again — it is how Novo claims Wegovy franchise leadership [7][5]. By NRx, Foundayo held a 21.5% share of the oral obesity market in late August, per a Jefferies note [7].
Reported versus adjusted growth can differ sharply because of the 340B provision reversals, as Novo’s H1 2026 numbers show [5]. Lilly’s Zepbound line is worldwide (US, Canada and Japan), while Mounjaro’s growth is heavily weighted outside the US [9]. And weekly counts move with the calendar: the July 4 week fell 5.1%, the Juneteenth week was down, and the Medicare GLP-1 Bridge program began July 1 [7].
Sources
- IQVIA. Obesity deep dive: The unparalleled launch success of Mounjaro and Zepbound. September 23, 2025.
- IQVIA. GLP-1 impact: How GLP-1s are changing the diabetes treatment paradigm. November 10, 2025.
- USA Today. Lilly weight-loss pill Foundayo shows strong first-week demand. April 17, 2026.
- CNBC. Wegovy pill sales smash forecasts, sending Novo Nordisk stock higher. May 6, 2026.
- Novo Nordisk. Financial report for the period 1 January 2026 to 30 June 2026. August 4, 2026.
- IQVIA. The outlook for obesity from 2026 to 2030. April 21, 2026.
- Fierce Pharma. The oral GLP-1 tracker: Novo’s Wegovy pill, Lilly’s Foundayo continue prescription climb. September 11, 2026.
- FinancialContent. The great GLP-1 divergence: Eli Lilly surges toward trillion-dollar dominance as Novo Nordisk falters on U.S. price cuts.
- Eli Lilly and Company. Lilly reports second-quarter 2026 financial results, raises full-year guidance, and highlights continued growth and pipeline progress. August 5, 2026.
- IQVIA. GLP-1s: The Swiss Army knife tackling more than obesity. November 13, 2025.
- Reuters. Obesity market sales potential tightens as Novo and Lilly enter new era. February 2, 2026.
- PR Newswire. FDA approves Novo Nordisk’s Wegovy pill, the first and only oral GLP-1 for weight loss in adults.
- Eli Lilly and Company. FDA approves Lilly’s Foundayo (orforglipron), the only GLP-1 pill for weight loss that can be taken any time of day without food or water restrictions. April 1, 2026.
Frequently asked questions
How many Americans are on a GLP-1 drug?
About 11 million unique US patients were using a GLP-1 across all indications as of the second quarter of 2025, according to IQVIA. Before 2022, only 1.8% of patients diagnosed with obesity — about 1.6 million people — had started any anti-obesity treatment.
Zepbound or Wegovy: which has more prescriptions?
Zepbound leads weekly totals — roughly 772,000 versus about 513,500 for the whole Wegovy franchise in early September 2026, per IQVIA data cited by Citi. Novo says the Wegovy franchise leads on new patient starts instead, and its CEO claimed 65% of new US prescriptions in Q1 2026.
How many Wegovy pill prescriptions have there been?
More than 5 million since the January 5, 2026 launch, as of Novo's August 2026 report — about 1.3 million in Q1 and about 2.9 million in Q2. Weekly totals reached roughly 183,000 by early September, per IQVIA data cited by Citi.
How is Foundayo selling?
Weekly prescriptions climbed from about 20,000 in early July to 47,500 by the September 11, 2026 update, per IQVIA data cited by Citi. First-quarter revenue was $98 million worldwide, including $67 million in the US, below the $130 million Wall Street consensus.
Where does IQVIA prescription data come from, and what are its gaps?
The weekly figures in press coverage are IQVIA data as cited by Citi or Jefferies analysts, not primary IQVIA publications. Citi says IQVIA may still miss Foundayo telehealth prescriptions, and Jefferies says early capture rates are volatile and may exclude sampling. Novo says capture rates should gradually improve; Lilly says early figures are best interpreted over time rather than as a complete count.
What do TRx and NRx mean?
TRx is total prescriptions, including refills. NRx is new prescriptions, excluding refills. New patient starts is a third, separate measure. By NRx, Foundayo held a 21.5% share of the oral obesity market in late August 2026, per a Jefferies note.
Is the GLP-1 market still growing in 2026?
By prescriptions, yes. Citi's September 2026 read showed total GLP-1 prescriptions up 5.4% over four weeks, versus a 6.8% decline a year earlier, which the analysts attributed to oral GLP-1s expanding the market. By revenue, forecasters have cut 2030 obesity market estimates by about 30% on price erosion.
This article summarizes FDA labeling, published research and company information current as of September 14, 2026. It is not medical advice and does not replace a conversation with your own healthcare provider. How we research and verify.