Novo's Wegovy pill still outruns Foundayo roughly four to one

Novo Nordisk's Wegovy pill is still the dominant oral GLP-1 drug in the United States, outpacing Eli Lilly's Foundayo by roughly four to one on weekly prescriptions as of mid-September 2026. According to IQVIA data cited by Citi, the Wegovy pill reached about 183,000 total prescriptions in its most recent reporting week, up slightly from 181,000 the week before, while Foundayo climbed nearly 8% to reach 47,500 scripts ^[2]. Novo has told investors its oral pill "is the strongest US GLP-1 volume launch to-date" ^[1].

The gap has narrowed somewhat since launch. Foundayo, which uses orforglipron and does not require the strict fasting and water rules tied to some oral GLP-1 formulations, has posted several weeks of consistent growth, including a nearly 8% weekly jump most recently, compared with roughly 1% growth for the Wegovy pill over the same period ^[2]. As of late August, Foundayo's share of new prescriptions — excluding refills — in the oral obesity market stood at 21.5%, according to a Jefferies note ^[2]. Still, within the broader Wegovy franchise, the oral pill's share of total Wegovy prescriptions has plateaued near 33% to 35% for months ^[2].

One structural reason cited for the Wegovy pill's lead is brand recognition. Wegovy and its sibling drug Ozempic are both built on semaglutide, a molecule doctors and patients already know well. Foundayo, by contrast, is a brand-new name attached to a chemically distinct, non-peptide molecule, meaning prescribers can't simply lean on existing experience with Mounjaro or Zepbound, Lilly's tirzepatide-based drugs, when deciding whether to write a Foundayo prescription ^[1].

Access and coverage timing also played a role early on. Wegovy had coverage across major pharmacy benefit managers from its first week on the market, while Foundayo did not gain that coverage until CVS came on board on June 1, 2026, months after launch ^[2]. The federal Medicare GLP-1 Bridge program, which began covering certain weight-loss drugs including Foundayo for a $50 monthly copay for Part D beneficiaries, went live July 1, 2026 ^[2]. Lilly executives, including USA president Ilya Yuffa, said the company was "starting to see an inflection point on Foundayo now" after broader direct-to-consumer marketing followed the June PBM wins ^[2]. Lilly's second-quarter Foundayo sales came in at $98 million total, including $67 million in the US, a figure some analysts called disappointing ^[2].

Across the full GLP-1 category, not just oral drugs, Lilly's tirzepatide held close to 57% of the total US market as of the most recent update, up from about 49.5% a year earlier, while Novo's semaglutide share held roughly flat at 37% ^[2].

Why it matters for patients

For patients weighing an oral GLP-1 option, the prescription gap partly reflects practical factors outside the drug itself: how long each pill has been covered by insurers, how familiar a doctor already is with the underlying molecule, and how much marketing has reached patients and prescribers. Citi analysts noted that total GLP-1 prescriptions rose 5.4% over the prior four weeks, compared with a 6.8% decline a year earlier, a swing they attributed largely to the expansion of oral options broadening access and pulling in new patients ^[2]. That suggests the pill format itself, not just brand choice, is changing who ends up on a GLP-1 drug. Coverage details, including copay programs like the Medicare GLP-1 Bridge, can also shape which drug ends up being more affordable for a given patient, separate from any question of clinical effectiveness.

What happens next

Fierce Pharma's tracker, based on IQVIA prescription data, is updated weekly and will continue to show whether Foundayo's faster percentage growth narrows the gap with the Wegovy pill or whether Novo's larger base keeps it in front ^[2]. Analysts will also watch how expanded PBM and Medicare coverage for Foundayo, now in place since June and July 2026, respectively, continues to affect uptake in the months ahead ^[2].