Wegovy prescriptions slip as Novo Nordisk's US obesity share falls to 39.9%
A shifting share split between Novo Nordisk and Eli Lilly shapes which obesity drugs get pharmacy coverage and how much attention the oral options get from insurers.
Novo Nordisk's total Wegovy prescriptions, counting the injectable and the oral pill, fell 1.1% to about 495,500 in the week covered by the Aug. 14, 2026 update of Fierce Pharma's Oral GLP-1 Tracker [1]. Over the same week, Novo gave up about 0.7 percentage points of U.S. obesity market share to Eli Lilly's Zepbound, leaving the split at 39.9% for Novo and 60.1% for Lilly, based on IQVIA data cited by Citi [1].
The oral version of semaglutide, sold as the Wegovy pill, slipped to about 163,000 prescriptions from a high of roughly 172,000 the week before [1]. The pill's share of all Wegovy prescriptions fell back to 33% from 35%; the tracker notes that its share within the Wegovy franchise has struggled for months to stay above one-third [1].
Eli Lilly's oral GLP-1, Foundayo, moved the other way. It recorded 38,928 prescriptions, up from a record 34,219 the week before [1]. That is still a fraction of the Wegovy pill's volume. Citi analysts caution that IQVIA may not capture some Foundayo prescriptions filled through telehealth channels, so it is not clear how much of the weekly growth reflects real new demand [1].
Wegovy pill prescriptions had been mostly flat since Medicare's GLP-1 Bridge program began on July 1, Jefferies analysts wrote in an Aug. 21 note [1]. That program covers certain weight-loss medicines, including Foundayo, at a $50 monthly copayment [1]. Lilly reported $98 million in Foundayo sales for the second quarter, including $67 million in the U.S., a result the tracker describes as disappointing to many [1]. CEO David Ricks said on the company's earnings call that Lilly began broad direct-to-consumer marketing after securing commercial access across the three major pharmacy benefit managers in June [1]. Ilya Yuffa, president of Lilly USA, said the company is "starting to see an inflection point on Foundayo now" [1].
Later tracker entries show both oral drugs recovering. In the Sept. 4, 2026 update, the Wegovy pill reached about 181,000 prescriptions, up 3%, and total Wegovy scripts rose 2.7% to 513,500, while Zepbound climbed 1.6% to a little under 772,000 [1]. In the Sept. 11 entry, the Wegovy pill hit about 183,000 and Foundayo reached 47,500, each a new high [1]. Across the prior four weeks, total GLP-1 prescriptions rose 5.4%, compared with a 6.8% decline in the same period a year earlier, a swing Citi attributed to oral GLP-1s broadening access to the class [1]. Lilly's tirzepatide held nearly 57% of the total GLP-1 market, up from about 49.5% a year earlier, while Novo's semaglutide stayed near 37% [1].
Why it matters for patients
Prescription counts and market share are a rough proxy for what patients are offered at the pharmacy counter. The tracker shows Lilly's Zepbound and Foundayo gaining volume while Novo's Wegovy slips, and it notes that CVS was the last of the big three pharmacy benefit managers to cover Foundayo, starting June 1, while Wegovy had full coverage in its first week on the market [1].
Citi analysts said oral GLP-1s appear to be bringing in new patients, which is one reason overall GLP-1 prescriptions are rising again after falling a year earlier [1]. Medicare's GLP-1 Bridge program, live since July 1, 2026, covers certain weight-loss medications, including Foundayo, for a $50 monthly copayment [1]. How many patients have enrolled, and how much of the recent prescription growth comes from that program, has not been reported [1].
The weekly figures are estimates, not a full count. Citi notes that IQVIA data may miss Foundayo prescriptions filled through telehealth, leaving the size of that drug's growth uncertain [1].
What happens next
The tracker is updated weekly using IQVIA prescription data cited by Citi and Jefferies [1]. Its most recent entry, dated Sept. 11, 2026, shows both oral drugs at record prescription levels, with the gap still wide: about 183,000 for the Wegovy pill versus 47,500 for Foundayo [1]. Whether Foundayo's telehealth-driven prescriptions become visible in the IQVIA figures, and how the roughly 40% to 60% obesity share split between Novo and Lilly evolves, has not been disclosed [1].
Sources
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