IQVIA puts 2025 obesity drug market at $66 billion and forecasts $92 billion for 2026
The $66 billion is a global list-price total, and IQVIA ties the wide 2027-and-later range to oral GLP-1s and cheaper semaglutide abroad rather than to any projected US prices.
The global market for obesity medicines reached $66 billion in list-price sales value in 2025, according to IQVIA's ForecastLink, and the research firm forecasts $92 billion in 2026 [1]. IQVIA published those figures on April 21, 2026, in an outlook covering 2026 through 2030 [1]. For 2027 and beyond, it gives a much wider range: $105 billion to $200 billion [1].
IQVIA attributes that spread to two forces it expects to shape pricing and access: oral therapies and off-patent semaglutide [1]. The numbers measure list-price sales value, not net revenue after rebates and discounts [1].
Generic semaglutide is the nearer-term factor. Semaglutide, sold as Ozempic, Wegovy and Rybelsus, began losing exclusivity in early 2026 across major markets including India, China, Brazil, Turkey and Canada, with exclusivity lost in India on March 20, 2026 [1]. Those countries together account for 38% of adults living with obesity worldwide [1]. Except for Canada, they are self-pay markets for obesity medicines, so price and consumer access drive what happens there [1]. IQVIA's tracking counts 74 Chinese developers, including contract manufacturers and full developers, many using synthetic approaches, with manufacturing also expanding in India and other geographies [1].
On the oral side, the Wegovy pill launched in the United States in January 2026 as the first oral GLP-1 approved for obesity [1]. IQVIA says that within eight weeks it captured about one-third of new-to-brand prescriptions, most flowing through cash-pay channels, and that roughly two-thirds of that volume came from people new to any GLP-1 therapy [1]. Eli Lilly's Foundayo (orforglipron), an oral small-molecule GLP-1, reached the US market in April 2026 [1]. Novo Nordisk's CagriSema, which combines semaglutide with cagrilintide, is described as moving closer to market [1].
Corporate activity has been brisk. Pfizer won a 2025 bidding war with Novo Nordisk for Metsera, agreeing to pay up to $10 billion [1]. AstraZeneca's 2026 partnership with China-based CSPC reflects growing interest in Chinese innovation and manufacturing capacity [1].
IQVIA also flags how long patients stay on treatment. Its Obesity Market Landscaping shows persistence varies markedly between brands and countries, reflecting differences in pricing, patient support and local treatment pathways, and social media intelligence shows patients most often cite tolerability as the reason they stop GLP-1 treatment [1]. A separate IQVIA review of more than 14,000 recorded promotional interactions across the US, UK and four EU countries found messaging shifting from basic weight-loss framing toward labeled benefits, with cardiovascular benefit for Wegovy and sleep apnea for Mounjaro and Zepbound showing the largest increase in mentions [1].
Why it matters for patients
More products, including pills, are entering a market that IQVIA says will no longer be a two-company contest [1]. Much of the near-term price pressure it describes comes from off-patent semaglutide outside the United States, where the markets losing exclusivity in 2026 are self-pay markets with the exception of Canada [1]. Whether or when cheaper generic semaglutide will reach US patients has not been reported.
IQVIA's figure that most early oral Wegovy volume ran through cash-pay channels, and that about two-thirds of those users had not taken a GLP-1 before, suggests convenience and lower prices may be drawing in people who were not previously on treatment [1]. The outlook does not report how insurers are covering these products.
Tolerability is the practical issue IQVIA highlights: patients most often name it as their reason for stopping, and the firm calls improving long-term adherence both a clinical and commercial priority [1]. Persistence rates differ by brand and by country, so experience on treatment may vary [1].
What happens next
IQVIA expects Eli Lilly's triple-agonist retatrutide on the market in 2027 or 2028, alongside Boehringer Ingelheim's survodutide and Amgen's once-monthly MariTide [1]. Two real-world studies should report later in the decade: SCoMIS, examining Wegovy use in the Scottish population, reads out by 2029, and SURMOUNT-REAL should show whether these medicines reduce events such as heart attacks, diabetes or disability at a health-system level [1]. IQVIA says such results could strengthen the case for broader public coverage [1]. It projects obesity medicines will be among the world's five most valuable therapy classes by 2030 [1].
Sources
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