The GLP-1 Pill Race: Pharma’s New Frontier
By Chantal Toft, Claret’s Life Sciences Team Pharma companies are racing to develop oral GLP-1 drugs, marking a new era in obesity treatment.GLP-1 drugs, once diabetes medications, have rocketed to fame as powerful weight-loss treatments. These drugs (GLP-1: glucagon-like peptide-1 receptor agonists) work by enhancing insulin and suppressing appetite, leading to significant weight loss.[1] In the past few years, injectables like Ozempic (semaglutide) and Mounjaro (tirzepatide) have become household names, driving widespread public and clinical attention. Demand is so high that by 2024 an estimated 8–10% of Americans were already taking a GLP-1 medication, with many more interested.[2] This unprecedented surge has turned the field into a pharma gold rush, with companies large and small vying for a piece of what some analysts predict could be a $150 billion market within a decade.[3]
From Injections to Pills – A Game Changer
Until now, patients had to take GLP-1 therapies via regular injections. That changed at the end of 2025, when Novo Nordisk’s Wegovy pill (oral semaglutide) became the first FDA-approved GLP-1 in tablet form for weight management.[4] The daily pill form offers similar efficacy, about 15–17% average weight loss in trials, but with the convenience of avoiding needles.[5] Novo Nordisk launched the pill in the US at the start of 2026, pricing it significantly lower than its weekly injections to make it widely accessible. Analysts noted this aggressive pricing (around $5 a day for starters) undercuts injectable versions, signaling an emerging price war in the sector. The appeal is clear: a once-daily obesity pill that is easier to fit into daily routines and more affordable could open treatment to many new patients.
Hot on Novo’s heels, Eli Lilly is developing its own oral GLP-1 pill called orforglipron. Lilly has indicated it would price its pill competitively (they floated a ~$399/month cap for high doses) once approved. Importantly, Lilly’s orforglipron is a small-molecule GLP-1 agonist (not a peptide) which could make manufacturing and scaling up easier. In clinical studies so far, orforglipron has shown promising weight loss results, and it’s expected to be the second major entrant in the oral category.[6]
A Crowded Field of Competitors
Novo Nordisk and Lilly, longtime diabetes competitors, are now head-to-head in obesity. Novo led with injectable Wegovy and briefly became Europe’s most valuable company, but Lilly hit back with Mounjaro/Zepbound, showing stronger weight loss and winning FDA approval in 2023. By late 2025, Novo’s stock had slipped due to supply issues and pressure from Lilly. Its new Wegovy pill is a key move to regain lost ground.
Beyond these two giants, other contenders are flooding in. Pfizer, for example, had to halt development of two earlier GLP-1 pill candidates over safety concerns, but quickly pivoted by acquiring a weight-loss biotech and licensing a new oral candidate from China’s Fosun Pharma.[7] Likewise, multiple biotechs are advancing candidates: industry analysts counted at least six different oral GLP-1 drugs in mid-to-late-stage development by late 2025. A few notable players include:
- Structure Therapeutics – reported an impressive ~11% placebo-adjusted weight loss at 36 weeks with its pill aleniglipron, sending its stock soaring. An extended study hinted at up to 15% weight reduction on higher doses.
- Viking Therapeutics – saw ~11% weight loss in just 13 weeks with its oral candidate VK2735, though side effects led to higher dropout rates (nearly 28% of patients, due to nausea). Slowing the dose ramp-up may improve tolerability.
- Ascletis Pharma (China) – entered the fray with a mid-stage oral GLP-1, but efficacy data put it in the mid-to-lower tier of this wave of candidates.[8]
Despite growing competition, Novo and Lilly remain in the lead, backed by scale and deep pipelines. Novo is advancing combo drugs like amycretin, which targets both GLP-1 and amylin, while Lilly is developing a triple-agonist, retatrutide, alongside other incretin candidates. The landscape echoes past pharma battles like the statin wars – high stakes, fast moves, and no shortage of ambition.
Beyond Weight Loss: New Horizons (and Hurdles)
Beyond obesity and diabetes, GLP-1s are being tested across a range of conditions with mixed results. On the upside, they’ve shown strong cardiovascular benefits – in 2025, oral semaglutide (Rybelsus) was approved to cut heart attack and stroke risk in high-risk type-2 diabetics. It also improved heart function in patients with obesity-related heart failure. Semaglutide (Wegovy) became the first approved treatment for NASH/MASH, resolving liver inflammation in nearly two-thirds of patients.[9] These wins hint at broader potential for GLP-1s in tackling complex metabolic and organ diseases.
However, not every bet has paid off. Notably, a hypothesis that GLP-1 medications could combat neurodegenerative diseases just faced a major setback. In late 2025, Novo Nordisk announced that two large trials of semaglutide in early Alzheimer’s disease (the EVOKE studies) failed to slow cognitive decline compared to placebo.[10] This outcome damaged the idea that GLP-1’s metabolic benefits might translate into protecting the brain. It was a reminder that these drugs, while powerful, are not magic bullets for every condition. Other research into GLP-1 for conditions like addiction and Parkinson’s continues, but it’s early-stage and uncertain.
The Road Ahead
GLP-1 drugs have rapidly evolved from diabetes treatments into a blockbuster category tackling obesity and more. With projected annual sales topping $100bn within a decade, the race is on, marked by fierce competition, bold partnerships, and constant innovation. Their impact rivals that of statins, but with unprecedented speed and uptake across patients, doctors, and investors alike.
Oral GLP-1 pills signal a new chapter, removing barriers and widening access. While side effects and pricing remain challenges, the momentum is undeniable. This is biotech at full throttle and the outcome of the GLP-1 race is still wide open.
