Novo Nordisk says Wegovy pill holds about 90 percent of the US oral GLP-1 market

Novo Nordisk chief executive Mike Doustdar said the company's Wegovy pill holds about 90 percent of the US oral GLP-1 market, a figure Novo has not backed with an independent breakdown and one that describes a market Eli Lilly's Foundayo had only just entered ^[1].

Doustdar made the comments in a Reuters interview published August 13 ^[1]. He also argued that obesity treatment will not be a winner-take-all contest, because patients want a choice of formats ^[1]. Novo's oral semaglutide is sold as the Wegovy pill and Lilly's oral orforglipron as Foundayo ^[1][2]. Foundayo was approved in April 2026, so the second quarter of 2026 was its first full quarter on the market ^[1][2].

The revenue gap so far is wide. Oral Wegovy brought in DKK 3.22 billion, or about $496 million, in the second quarter of 2026, while Foundayo recorded $98 million, according to figures reported by BioSpace ^[2]. Novo's own quarter lists the Wegovy pill at DKK 3.22 billion against DKK 3.27 billion expected ^[1]. Lilly's tirzepatide franchise — Mounjaro for type 2 diabetes and Zepbound for chronic weight management — still took in $9.9 billion in the quarter, including $4.9 billion in US Zepbound sales ^[1].

Analysts told BioSpace the early lead reflects more than who launched first. Sadaf Javed of DelveInsight called the results "striking" and said Novo extended an existing brand into a pill, letting it use physician familiarity, patient awareness and semaglutide experience instead of building a new obesity brand from scratch ^[2]. Sara Reci of GlobalData credited a "structural first-mover benefit and the exceptional brand equity of the semaglutide franchise," and said the oral market "at least in its early phase, favors Novo Nordisk" ^[2].

Efficacy comparisons come with a caveat: there has been no head-to-head trial of the two pills ^[2]. Across separate trials, oral Wegovy produced around 16.6 percent average weight loss at 72 weeks, versus 11.2 percent for Foundayo at the same point, BioSpace reported ^[2]. Reci said the efficacy edge Lilly used to overtake Novo in injectables has "reversed" in orals, "removing the key lever that allowed Lilly to dislodge Novo in injectables so quickly" ^[2].

Lilly's counter is convenience and manufacturing. Oral Wegovy must be taken with water and cannot be followed by food or drink for at least 30 minutes; Foundayo has no such restriction ^[2]. Foundayo is also a small molecule rather than a peptide, which analysts said makes it cheaper and easier to make and could let Lilly compete on price, particularly outside the US ^[2].

Overseas, the oral race is only starting. On August 10, UK regulators authorized Foundayo for weight management and type 2 diabetes, the first approval in Europe ^[1]. Private prescriptions were expected within weeks, while National Health Service funding depends on a separate NICE appraisal that typically takes 12 to 18 months, making funded access unlikely before late 2027 ^[1].

Why it matters for patients

For patients, the practical questions are what is actually available, how easy it is to take and what it costs — not who leads in market share.

Two oral options now exist in the US: the Wegovy pill (oral semaglutide) and Foundayo (orforglipron). They differ in daily routine, since one requires water and a 30-minute wait before eating or drinking, and in the average weight loss reported from separate trials, which are not a head-to-head comparison ^[2]. Whether those differences matter for any one person is a question for a clinician.

Cost and coverage remain unsettled. The UK authorization of Foundayo is separate from NHS funding, which is unlikely before late 2027 ^[1]. In the US, no independent breakdown of oral GLP-1 market shares has been published, so the 90 percent figure cannot be confirmed from outside the company ^[1]. Novo's share is also being measured while Foundayo is still in its first months of sales; how the split looks once Lilly's sales force and direct-to-consumer reach are fully deployed has not been reported ^[2].

Patients may also want to track the next-generation products. CagriSema, Novo's combination of semaglutide and cagrilintide, is listed on a sector calendar with an FDA decision expected in the second half of 2026 ^[1]. Phase 3 data previously fell short of the bar Novo had set, erasing about $72 billion in market value at the time ^[2].

What happens next

• Foundayo's UK launch: private prescriptions were expected within weeks of the August 10 authorization, with NHS funding unlikely before late 2027 pending a NICE appraisal ^[1].
• CagriSema: an FDA decision is expected in the second half of 2026, according to a sector catalyst calendar ^[1].
• Quarterly sales from both companies will be the clearest public read on whether Novo's oral lead holds; no independent market-share breakdown has been published ^[1][2].