Novo and Lilly: FDA Approval of Wegovy Pill Launches New Obesity Battle

Novo Nordisk NVO received Food and Drug Administration approval for its Wegovy pill as a treatment for obesity on Dec. 22. The company plans to launch the 25mg semaglutide pill in the United States in early January. Novo shares were up roughly 9% in early Dec. 23 trading.

Why it matters: Novo has been losing market share to Eli Lilly LLY in the injectable GLP-1 market across diabetes and obesity since 2024. With the first oral GLP-1 launch, it has a chance to seize a brief commercial advantage ahead of Lilly’s potential orforglipron launch this spring.

• We expect the most important channel in the first few months of 2026 will be direct-to-patient sales, where Novo will sell its Wegovy pill for $150 a month at the starting dose. We expect subsequent doses in this channel at closer to $350 per month (in line with injectable Wegovy).
• Weight loss generated by the Wegovy pill in the Oasis 4 study looked numerically better than Lilly’s orforglipron in the Attain-1 study, and Wegovy’s well-known safety profile could persuade doctors to more readily prescribe its pill version, at least initially.

The bottom line: We’re maintaining our fair value estimates of $66 per share for wide-moat Novo and $770 for wide-moat Lilly following this news and other recent events in the obesity space. We continue to see Novo’s long-term innovation as underappreciated.

• High-dose injectable Wegovy is poised for US and EU approval in early 2026, following a positive regulatory opinion in Europe and a US filing in November with a national priority voucher. This launch—and the recent CagriSema filing—should help Novo regain its footing against Lilly.
• Lilly’s data for triple agonist retatrutide (Dec. 11) and orforglipron maintenance (Dec. 18) could drive us to allocate part of our tirzepatide forecast (currently peaking at $75 billion in 2031) across these molecules. However, Structure Therapeutics’ Dec. 8 aleniglipron data highlights a potential competitor.