Tirzepatide reaches nearly 57% of US GLP-1 prescriptions as oral drugs lift the market
Tirzepatide's share of U.S. GLP-1 prescriptions keeps climbing while oral options post record weekly counts, a shift that affects which drugs patients are most likely to be offered and how they are covered.
Eli Lilly's tirzepatide now accounts for nearly 57% of all GLP-1 prescriptions written in the United States, up from about 49.5% a year earlier, according to IQVIA data cited by Citi. Novo Nordisk's semaglutide held roughly flat at a 37% share [1].
The market-share shift is happening as the overall GLP-1 category returns to growth. Total GLP-1 prescriptions rose 5.4% over the most recent four weeks, compared with a 6.8% decline in the same stretch a year earlier. Citi analysts attributed that 12-percentage-point swing to the expansion of oral GLP-1 therapies, which they said is likely broadening access to the class and drawing in new patients [1].
Both oral GLP-1 drugs posted their highest weekly prescription counts to date in the most recent reporting period. Novo's Wegovy pill, oral semaglutide, reached about 183,000 total prescriptions, up from 181,000 the week before. Lilly's Foundayo, the molecule orforglipron, climbed nearly 8% to 47,500 prescriptions [1]. Citi noted that IQVIA may still be missing some Foundayo prescriptions filled through telehealth channels, which means the reported figure could understate actual use [1].
Among the injectables, total Wegovy prescriptions — the pill plus the injectable — rose 2.7% to 513,500, with the pill accounting for 35% of that total, unchanged from the prior week. Zepbound prescriptions climbed 1.6% to a little fewer than 772,000 [1]. In a note dated Aug. 28, Jefferies analysts put Foundayo's share of new prescriptions, which exclude refills, at 21.5% of the oral obesity market [1].
Lilly has reported $98 million in total Foundayo sales for the second quarter, including $67 million in the U.S., after the drug secured commercial access across the three major pharmacy benefit managers in June. The Medicare GLP-1 Bridge program went live July 1, offering coverage for certain weight-loss medications, including Foundayo, at a $50 monthly copayment [1].
Why it matters for patients
The latest figures describe what U.S. clinicians are writing, not how well any drug works. Nothing in the data compares tirzepatide and semaglutide head-to-head on weight loss or side effects; these are market-share numbers, not effectiveness numbers [1].
What has changed is the mix of options and how they are covered. Tirzepatide — sold as Mounjaro for diabetes and Zepbound for obesity — is now the most-prescribed GLP-1 in the country by this measure [1]. Oral choices are growing as well: the Wegovy pill and Foundayo both set weekly prescription records in the latest period [1]. Lilly is betting that Foundayo's freedom from strict fasting and water requirements can give it an edge over the Wegovy pill, according to the company's positioning described in the tracker [1].
Coverage is another moving part. The Medicare GLP-1 Bridge program, which began July 1, covers certain weight-loss medicines including Foundayo at a $50 monthly copayment, though the tracker notes Wegovy prescriptions have been relatively flat since the program started [1]. And because Citi says IQVIA may not capture all telehealth prescriptions, the real volume of oral GLP-1 use could be higher, or growing faster, than the published weekly counts show [1].
What happens next
No date has been disclosed for when IQVIA's telehealth coverage might improve, and it is not known how much of Foundayo's recent prescription growth reflects better data capture rather than faster growth in telehealth channels [1]. The weekly trackers will continue to update, but the latest figures include no future dates for company milestones [1].
Sources
Semaglutides.org provides information only, not medical advice. Talk to a licensed provider about your own care before making changes. Some telehealth links are affiliate links and are labeled where they appear.