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Does NVO Face Rising Competitive Pressure on LLY's Foundayo Approval?

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Key Takeaways

  • Eli Lilly's Foundayo approval introduces a direct oral GLP-1 rival to Novo Nordisk's Wegovy pill.
  • LLY's strong execution and Zepbound's rapid share gains highlight its growing obesity market momentum.
  • Novo Nordisk cites data showing the Wegovy pill may outperform Foundayo on weight loss and tolerability.

Danish drugmaker Novo Nordisk (NVO - Free Report) is a dominant player in the cardiometabolic space, mainly due to the encouraging uptake of its blockbuster semaglutide-based (GLP-1) drugs — Ozempic (for type II diabetes [T2D]) and Wegovy (for obesity). In late 2025, NVO expanded its obesity portfolio, securing FDA approval for oral Wegovy, the first GLP-1 therapy in pill form for weight management, in the United States, which was launched in early 2026.

This initially gave the company a huge head start over its nemesis in the obesity space, Eli Lilly (LLY - Free Report) , which markets its tirzepatide (GLP-1) injections as Mounjaro for T2D and Zepbound for obesity. Eli Lilly’s Mounjaro and Zepbound directly rival Novo Nordisk’s Ozempic and Wegovy, and have recently gained significant market share, driven by stronger efficacy and superior commercial execution, fueling rising demand.

Earlier this month, Eli Lilly received FDA approval for its oral GLP-1 therapy, orforglipron, and subsequently launched it under the brand name Foundayo for adults with obesity or overweight with weight-related medical problems. A key differentiating factor is that the pill can be taken at any time of the day without food or water restrictions. When combined with a reduced-calorie diet and increased physical activity, Foundayo is designed to help individuals lose excess weight and maintain long-term weight management.

This makes Foundayo a direct competitor to NVO’s Wegovy pill. Lilly has already seen tremendous success with its tirzepatide injections. Despite being on the market for just over three years, Mounjaro and Zepbound have seen exceptional sales growth, becoming LLY’s key top-line drivers.

Investors should note that Eli Lilly launched Zepbound for obesity in December 2023, several years after Novo Nordisk introduced the Wegovy injection. Despite the later entry, Zepbound rapidly gained share, ultimately surpassing Wegovy’s sales in 2025. If this trajectory is any indication, Lilly could once again outpace Novo Nordisk, supported by strong commercial execution and competitive pricing strategies to expand patient access.

However, Novo Nordisk recently presented new indirect comparative data suggesting that its oral Wegovy (semaglutide 25 mg) may offer superior clinical outcomes to Eli Lilly’s oral GLP-1 therapy, Foundayo (orforglipron 17.2 mg). Based on a population-adjusted indirect treatment comparison using data from separate late-stage studies, the Wegovy pill demonstrated a statistically greater reduction in body weight compared to Foundayo. The analysis also indicated a more favorable tolerability profile, with significantly lower odds of treatment discontinuation, particularly due to gastrointestinal side effects, which are a key consideration in obesity therapies.

Additional patient preference data reinforced this positioning, with a large majority of surveyed individuals favoring a treatment profile aligned with oral semaglutide rather than one resembling Foundayo. Taken together, these findings suggest that Novo Nordisk views its Wegovy pill as clinically differentiated on both efficacy and tolerability.

Nevertheless, investors should bear in mind that the comparison is based on indirect analyses rather than head-to-head studies, and methodological limitations mean the results should be interpreted with caution when assessing the competitive landscape.

Competition Heating Up in the Obesity Space

The obesity space has garnered much of the spotlight over the past year due to the sizeable and still underpenetrated market opportunity. Smaller biotechs like Structure Therapeutics (GPCR - Free Report) and Viking Therapeutics (VKTX - Free Report) are also developing GLP-1-based therapies to challenge the incumbents.

Viking Therapeutics’ dual GIPR/GLP-1 receptor agonist, VK2735, is being developed both as oral and subcutaneous formulations for the treatment of obesity. Viking Therapeutics plans to advance oral VK2735 into phase III development for obesity in the third quarter of 2026.

Structure Therapeutics’ phase II ACCESS study on its orally GLP-1 RA, aleniglipron, for obesity, met its primary and all key secondary endpoints. Structure Therapeutics expects to initiate the late-stage program of aleniglipron in obesity in the second half of 2026.

NVO’s Stock Price, Valuation & Estimates

Year to date, Novo Nordisk shares have lost 25.3% compared with the industry’s 2.4% decline. The company has also underperformed the sector and the S&P 500 during the same time frame, as seen in the chart below.

NVO Stock Underperforms the Industry, Sector & the S&P 500

Zacks Investment ResearchImage Source: Zacks Investment Research

Novo Nordisk is trading at a discount to the industry, as seen in the chart below. Going by the price/earnings ratio, the company’s shares currently trade at 11.24 forward earnings, which is lower than 17.17 for the industry. The stock is trading much below its five-year mean of 29.25.

NVO Stock Valuation

Zacks Investment ResearchImage Source: Zacks Investment Research

Earnings estimates for 2026 have improved from $3.34 to $3.37 per share over the past 60 days. During the same time frame, Novo Nordisk’s 2027 earnings estimates have increased from $3.31 to $3.41.

NVO Estimate Movement

Zacks Investment ResearchImage Source: Zacks Investment Research

Novo Nordisk currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

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