It’s a tale of two drugmakers in the red-hot obesity drug market. 

Both Novo Nordisk and Eli Lilly are grappling with lower prices in the U.S., but their 2026 outlooks are diverging sharply: While Novo is bracing for a sales decline, Lilly sees revenue jumping again thanks to its blockbuster medicines. 

The split in guidance – despite similar headwinds – underscores the strength of Lilly’s position in the obesity and diabetes drug market, underpinned by its more effective injections and early foray into direct-to-consumer sales, among other factors. While Novo Nordisk effectively made the drugs mainstream, Lilly has since taken a clear edge in market share — and the forecasts show it will likely only extend its advantage this year.

“The difference in sales momentum and market share trend was visible throughout 2025, but the dichotomy between the two companies’ prospects was accentuated within this 24-hour period in which Novo guided below consensus and Lilly guided above consensus expectations,”  Leerink Partners analyst David Risinger told CNBC on Wednesday. 

“That really solidified an investor’s mind that Lilly is going to be the dominant player in obesity going forward,” he added. 

This year, all eyes will be on how Lilly’s upcoming obesity pill, orforglipron, fares against Novo’s own oral Wegovy drug, which has had an explosive U.S. launch this year.

In an interview on CNBC’s “Squawk Box” on Wednesday, Lilly CEO Dave Ricks said 20 million to 25 million patients are currently taking both companies’ medicines. But he said the total addressable market of patients in the obesity space is “gigantic.” 

Lilly similarly pointed to a “global pricing decline in the low- to mid- teens [percentages] this year.” That comes after the landmark “most favored nation” deals both companies struck with President Donald Trump in November to slash obesity and diabetes drug costs, along with their recent efforts to further reduce direct-to-consumer prices for their treatments. 

The agreements with Trump are expected to take a bite out of both companies’ sales, but eventually increase volumes of prescriptions for their drugs. Still, Lilly is bullish about other factors that will help offset that pricing pressure. 

That includes continued worldwide demand for its obesity drug Zepbound and diabetes counterpart Mounjaro and the expected launch of its GLP-1 pill for obesity in the second quarter, pending U.S. approval. Lilly also pointed to government Medicare coverage of obesity treatments starting for the first time by at least July, one of the winning features of the drug pricing deals with Trump. 

Lilly’s Ricks told CNBC that coverage will open up access to 40 million new Medicare beneficiaries, “and that could be quite expansive to volume.”

Overall, Risinger called Lilly’s guidance “very encouraging” and said the “price per volume trade-off is playing out well” for the company.

He said tirzepatide, the active ingredient in Zepbound and Mounjaro, is “superior” in its effectiveness and tolerability compared to semaglutide, the ingredient in Novo’s obesity and diabetes drugs. That was proven in a head-to-head clinical trial conducted by Lilly in 2024, and prescription trends show that the company’s drugs are preferred among prescribers.  

“I think that’s what is driving Lilly’s market share gain” relative to Novo, Risinger said. 

Another factor that sets Lilly and Novo apart is patent exclusivity. While Novo said expiring patents in some international markets pose a challenge, Lilly’s Ricks said tirzepatide should be protected into “the back half of the 2030s” in major markets. 

Risinger noted that Lilly is still working to drive global uptake for tirzepatide, which won U.S. approval for obesity in 2023. 

The Super Bowl is prime real estate every year for advertisers eager to get their brands in front of millions of consumers at once. It’s also costly.

That’s why a small subset of ad space for streaming-only commercials is gaining traction and granting smaller brands time during TV’s biggest night of the year.

Comcast’s NBC broadcast network will air Super Bowl 60 this year, with the Seattle Seahawks and New England Patriots facing off from Levi’s Stadium in Santa Clara, California. NBC’s streaming service, Peacock, will simulcast the event. While streaming has generally become the overwhelmingly popular way to consume content, the Super Bowl is still primarily watched via the broadcast network.

The streaming simulcast — gaining viewers each year — features certain ad spots earmarked only for that audience.

Streaming-only spots make up about 10% of the full ad inventory during the Super Bowl and cost about half of what a traditional TV commercial goes for, said Mark Marshall, NBC’s chairman of global advertising and partnerships.

“So cheaper, but still not cheap,” said Marshall. “And part of it is also you don’t have many of these spots, right? So I think people caught on to this trick over the past couple years, and it’s done really well in streaming. And as a result, a lot of people are lining up and wanting to do that.”

Each year the cost of the national ads for the Super Bowl breaks a record. NBC sold out of ad inventory for the Super Bowl, averaging $8 million per 30-second commercial, with between five and 10 ads selling for more than $10 million each, CNBC previously reported.

The streaming-only ads, which still appear nationally, fill the slots that would host regional commercials during the traditional TV broadcast.

These spots bring in new advertisers outside of the mainstays like Budweiser and Lay’s. All of the Peacock-only commercials this year are new advertisers to NBC’s Super Bowl slate, Marshall said. For example, cowboy boots brand Tecovas and family location safety app Life360 both bought streaming-only ad spots this year.

The chief marketing officers for both brands noted the impact of the Super Bowl — as well as steep cost — in explaining their decision to go all in on Peacock.

Tecovas CMO Krista Dalton in an email called the company’s debut via streaming “a deliberate choice,” allowing the brand to get the impact of the Super Bowl with “a highly engaged environment while staying disciplined with our investment.”

Life360 CMO Mike Zeman said via email, “Streaming is a great way for us to test what being integrated into such a monumental cultural moment can deliver to our brand and business. It allows us to reach a massive, highly engaged audience of modern, connected families with an ‘out of pocket’ investment that doesn’t break the bank or occupy too large a percentage of our overall marketing budget.”

Last year nearly 128 million viewers watched the Super Bowl on TV and via streaming, according to Nielsen.

While NBC has had a digital offering for its last four Super Bowl telecasts, Marshall said more advertisers have been vying for streaming space as the platform reached 44 million subscribers.

And fittingly, that growth has been driven largely by NBC’s push into live sports. This month NBC will air the Super Bowl and the Winter Olympics — which begin on Friday — along with the NBA All-Star game. It’s a live sports slate the company is billing as “Legendary February.”

“It’s obviously a huge year for NBC, and Peacock is more sold out than usual. We’re seeing a lot of brands leaning in with Peacock,” said Doug Paladino of ad agency PMG.

Paladino noted brands have seen good results advertising during “Sunday Night Football” games that are simulcast on Peacock, particularly due to the audience targeting capabilities on streaming.

The streaming-only commercials can also be something of an on-ramp for burgeoning brands that want to get their foot in the door of the big game.

Last year, direct-to-consumer health startup Ro bought its first ad during the Super Bowl — on Fox’s streaming service Tubi.

“The results that they got out of the Super Bowl for what they paid were an order of magnitude above what the traditional spot is,” said Philip Inghelbrecht, co-founder and CEO of ad tech firm Tatari, which worked with brands to place streaming-only and traditional TV ads in the Super Bowl, including Ro in both 2025 and 2026.

This year, Ro, which offers access to GLP-1 medications and telehealth appointments, ramped up its commitment to the Super Bowl and bought a spot in the traditional game broadcast on NBC. Tennis superstar Serena Williams will anchor the ad.

“Last year we dipped our toes into advertising in the Super Bowl through a buy on Tubi. It was a really attractive chance for us to really understand how our brand and our creative performed in that environment,” said Will Flaherty, senior vice president of growth at Ro.

Smaller brands have other more-affordable options to test the waters, too.

Manscaped, the men’s grooming company, decided to buy a spot before kickoff — a time slot less coveted than during the game itself, but still pricey — to push the next chapter of its business.

“Manscaped is a brand that has been around for a few years now, but we’re at this very important moment in our trajectory, which is a big push for products beyond the groin, which is our first claim to fame,” said Chief Marketing Officer Marcelo Kertesz. “We have something new to communicate to the world.”

“We know the spot itself is just one piece of it, a very important and very expensive piece of it, but it does make sense for us to do that in this moment,” said Kertesz. “It’s a desire I would guess all brands, at some point, have to be on that stage.”

Disclosure: CNBC parent Versant is carrying NBC Sports-produced Olympic coverage on its networks, including USA Network and CNBC.