Lilly CEO says about one-third of new GLP-1 pill patients start on Foundayo, breaks ground on new plant

Eli Lilly CEO Dave Ricks said on September 21 that about one-third of patients newly starting an oral GLP-1 medicine are being put on Foundayo (orforglipron), the company's weight-loss pill, and that the company's share of the pill market is growing week over week ^[2][4]. He spoke in a CNBC interview the same day Lilly broke ground on a $6.5 billion manufacturing plant in Houston that will make the active ingredient for the drug ^[2][5].

That share is up from what Lilly described in early August, when management said new starts for Foundayo were at "nearly one in four" ^[1]. Foundayo reached the US market on April 9, months after Novo Nordisk's Wegovy pill (oral semaglutide) debuted in January, and early prescription data showed a slow start for Lilly ^[1]. Lilly's pill can be taken any time of day with no restrictions on food or drink, while Novo's pill is generally considered somewhat more effective for weight loss ^[1][5]. "So far, so good," Ricks said ^[1].

Medicare is pulling in new patients

Ricks said roughly 700,000 seniors have started GLP-1 medications for obesity since July 1, when Medicare began covering obesity drugs for the first time, and that Lilly's products account for about 70% of those new patients ^[1][3]. Coverage runs through a temporary program called Bridge, which lets eligible beneficiaries get weight-loss drugs for a $50 monthly copay ^[1][3]. Lilly has said 20 million people are potentially eligible under Bridge, which is set to last through the end of 2027 ^[1]. Medicare covers about 66 million people overall ^[3].

Ricks said many of those enrollees are new to the drug class rather than switching from cash-pay prescriptions, calling the rollout "very market expansionary" ^[1]. He said physicians still appear to be steering patients with the highest body weight and most complications toward Zepbound, Lilly's tirzepatide injection, while Foundayo plays a bigger role for people who want a convenient option and "maybe just need to lose 25 to 30 pounds" ^[3]. He added that he has not heard of many logistical problems, saying the Centers for Medicare and Medicaid Services "did a nice job rolling this out" ^[3].

Lilly said in August it held about 61% of the overall US GLP-1 market in the second quarter, covering obesity and diabetes and both injections and pills, compared with about 39% for Novo ^[1][2]. Foundayo booked $98 million in sales in the second quarter, its first on the market ^[1][2]. Wall Street expects $261 million for the July–September quarter and $553 million for October through December ^[1].

The Houston plant

The new site at Generation Park in northeast Houston will make active pharmaceutical ingredients for Foundayo and other small-molecule medicines across cardiometabolic health, oncology, immunology and neuroscience, plus advanced therapeutics such as oligonucleotides ^[2][5]. Lilly expects it to be operational by 2030 and to employ more than 600 people, with about 4,000 construction jobs ^[2][5][6]. Accounts of the site's size differ slightly: CNBC described roughly 240 acres, while Axios reported 236 acres ^[2][6]. Lilly is also putting $12.5 million into a workforce training relationship with San Jacinto College and $2.5 million into scholarships ^[5].

It is one of ten US manufacturing sites Lilly has announced since 2020 as part of a more than $50 billion reshoring push ^[2][5].

Why it matters for patients

For people on or considering a GLP-1, the numbers point to two practical things: more manufacturing capacity aimed at pills, and a new payer covering obesity drugs. Foundayo is a small molecule rather than a peptide, which Lilly says makes it more readily scalable, and pills do not need refrigeration the way injectables do ^[5][1]. Ricks said the Texas plant will eventually supply Foundayo worldwide ^[1].

Coverage details still matter more than headlines. The $50 Bridge copay applies only to eligible Medicare beneficiaries and is scheduled to end after 2027 ^[1]. Whether it is extended has not been reported.

What happens next

Foundayo is under regulatory review in more than 40 countries, with a full global rollout targeted for 2027 ^[5]. Lilly is also studying the drug in type 2 diabetes and obstructive sleep apnea, with data expected later this year ^[5].