IQVIA sizes the global obesity medicines market at $66 billion for 2025

Analytics firm IQVIA published a forecast on April 21, 2026 that puts the global obesity medicines market at $66 billion in list-price sales for 2025, rising to $92 billion in 2026 and landing somewhere between $105 billion and $200 billion from 2027 onward ^[1]. The unusually wide range reflects two forces IQVIA says it cannot yet pin down: oral GLP-1 pills and semaglutide going off patent in major markets ^[1].

What the numbers cover

The figures come from IQVIA's ForecastLink database and are measured at list price, not the discounted or rebated price payers and patients actually end up paying ^[1]. The company frames the rest of the decade as three periods: 2025–2026 as an "inflection point" of new launches, 2027–2028 as an era of differentiation and generic expansion, and 2029–2030 as an "era of reckoning" when real-world evidence arrives ^[1]. IQVIA expects obesity medicines to become one of the world's five most valuable drug classes by 2030 ^[1].

Pills and patent expirations drive the forecast

Semaglutide — the molecule in Ozempic, Wegovy and Rybelsus — began losing exclusivity in early 2026 across India, China, Brazil, Turkey and Canada, with India's patent expiring on March 20, 2026 ^[1]. Those countries together account for 38% of adults living with obesity worldwide ^[1]. IQVIA counts 74 Chinese developers and contract manufacturers now working on generic semaglutide, with growing activity in India and elsewhere ^[1]. With the exception of Canada, those markets are largely self-pay, so consumer prices will shape how quickly generics spread ^[1]. The United States is not on that list; the source does not address when US semaglutide patents expire.

On the branded side, the oral version of Wegovy launched in the US in January 2026 as the first oral GLP-1 approved for obesity ^[1]. Within eight weeks it captured roughly one-third of new-to-brand prescriptions, with most volume moving through cash-pay channels ^[1]. About two-thirds of that volume came from people new to any GLP-1 therapy, which IQVIA reads as evidence that convenience and lower prices are expanding the market rather than just pulling people off injections ^[1]. Eli Lilly's Foundayo (orforglipron), a small-molecule oral GLP-1, reached the US market in April 2026 ^[1].

Competition is also broadening beyond Novo Nordisk and Lilly. Pfizer won a 2025 bidding war with Novo Nordisk for Metsera and its obesity pipeline in a deal worth up to $10 billion ^[1]. In China, Innovent launched mazdutide (Xinermei) in 2025 and Sciwind launched ecnoglutide in 2026 ^[1]. IQVIA expects Lilly's triple agonist retatrutide, Boehringer Ingelheim's survodutide and Amgen's once-monthly MariTide to arrive in the 2027–2028 window ^[1].

Why it matters for patients

Market forecasts are not clinical news, but they describe the conditions that determine price, supply and choice. IQVIA's own analysis says self-pay will keep leading access in many countries, pushing companies toward direct-to-patient models, employer programs such as Lilly Employer Connect, and digital health platforms ^[1]. In practice, that means more of the buying decision — and more of the cost — may sit with individuals rather than insurers in some markets.

IQVIA also flags that marketing is shifting away from weight loss alone. Reviewing more than 14,000 recorded promotional interactions across the four largest EU markets, the UK and the US, it found the biggest increases in messages about cardiovascular benefits for Wegovy and sleep apnea for Mounjaro/Zepbound (tirzepatide) ^[1]. By 2029–2030, IQVIA predicts differentiation will hinge on tolerability, outcomes beyond weight loss, and the quality of weight loss including muscle and bone preservation ^[1].

One persistent problem gets named directly: people stop taking these drugs. IQVIA reports that persistence varies sharply by brand and country, and that social media data show tolerability — side effects — is the reason patients most often cite for quitting ^[1].

What happens next

IQVIA expects semaglutide generics to spread through the newly off-patent markets during 2026 ^[1]. Retatrutide, survodutide and MariTide are slated for 2027–2028 ^[1]. Two large real-world studies — SCoMIS, tracking Wegovy use across the Scottish population, and SURMOUNT-REAL — are expected to read out by 2029 and could show whether these drugs cut cardiovascular events, diabetes or disability at a population level ^[1]. IQVIA says those results could strengthen the case for broader public coverage ^[1].