By Peter Loftus

The weight-loss pill wars start now.

Eli Lilly's once-daily pill for weight loss got approval from U.S. drug regulators. The all-clear sets up a battle with rival Novo Nordisk, which has been selling a pill version of its Wegovy since the start of this year.

The Wegovy pill has had one of the best drug launches in history. Now that the Food and Drug Administration has approved its pill, Lilly will seek to overtake the rival, and further its dominance of the booming $70 billion-plus market for weight loss and diabetes drugs known as GLP-1s.

"It will be a battle royal for GLP-1 pill leadership between Novo and Lilly," Leerink Partners analyst David Risinger said.

Lilly has won a weight-loss fight before: While Novo Nordisk pioneered the use of GLP-1 drugs for weight loss with its Wegovy and Ozempic weekly injections, Lilly's Zepbound and Mounjaro injections now outsell them.

Yet Novo Nordisk plans to avoid the mistakes that hurt it during the last round, and will seek to hold on to its early lead by emphasizing the effectiveness of its pill.

Analysts are betting on Lilly, expecting its pill, named Foundayo, to generate about $21 billion in global sales by 2030, compared with $4 billion for the Wegovy pill, according to pharmaceutical commercial intelligence firm Evaluate.

Obesity pills are the newest frontier for weight-loss drugs. Injectable versions of Wegovy and Zepbound generated a combined $26 billion in sales last year, but millions of people who could take the GLP-1 drugs have shied away.

Both companies are betting there is a big untapped market of overweight people who would favor a pill instead. Some don't like needles. Others don't view their weight as problematic enough to warrant an injection, but might find a pill more palatable.

The Wegovy pill's strong start is a sign the bets will pay off. The new drug racked up more than 94,000 U.S. prescriptions the week ended March 20 -- the 11th week after its launch -- many of them for people who haven't previously taken a weight-loss shot.

"We anticipate the same level of interest for" Lilly's pill as has been seen for the Wegovy pill, Ilya Yuffa, president of Eli Lilly's U.S. unit, said in an interview.

Indianapolis-based Lilly overtook Denmark's Novo Nordisk with the shots by emphasizing studies showing Lilly's medicines helped people lose more weight.

With the pills, however, it is the other way around. Novo's Wegovy pill helped people lose about 16.6% of their body weight on average when taken for 64 weeks in a trial. For Lilly's pill, it was an average reduction of 12.4% after 72 weeks.

"That has to matter," Novo Nordisk Chief Executive Mike Doustdar said in an interview. Novo's pill is also approved to reduce the risk of heart attacks and strokes in overweight people.

Lilly doesn't think the lower weight-loss results for its pill, when compared with the Wegovy pill, will put it at a big disadvantage. The company thinks weight loss in the 10% to 15% range is compelling enough to land customers.

And Lilly sees a big advantage for its own product. The company plans to tout a lack of restrictions on its pill when compared with Novo's, which has to be taken first thing in the morning on an empty stomach before waiting a half-hour to eat or drink.

"It's all about simplicity and convenience," Lilly Chief Financial Officer Lucas Montarce said in an interview. "You don't need to think about if you have taken water or food in the last 30 minutes."

The company is so confident in demand that it has built up an inventory of nearly $1.5 billion worth of pills, according to a company securities filing.

Lilly's pill launch may not be as brisk as Novo Nordisk's, Leerink's Risinger said, because Lilly will be establishing a new brand and the Wegovy pill has already nabbed a lot of prescriptions for people interested in pills.

Yet Risinger expects Lilly's pill will eventually outsell the Wegovy pill because Lilly can manufacture a bigger supply at a lower cost than Novo Nordisk, and potentially roll it out to more countries outside the U.S.

Both Lilly and Novo are making the starting doses of their pills available for $149 a month cash for self-pay patients, under deals they signed with the Trump administration last fall.

People with insurance coverage of the drugs may pay as little as $25 a month for Wegovy or Foundayo, using copay assistance from the manufacturers. The weekly shots originally had list prices of up to $1,350 a month, though prices have come down.

Write to Peter Loftus at Peter.Loftus@wsj.com

(END) Dow Jones Newswires

April 01, 2026 11:38 ET (15:38 GMT)