The booming GLP-1 space was built on weekly injections. In 2026, new obesity pills will push the market into its next chapter.

Patients are already getting their hands on the first GLP-1 pill for obesity from Danish drugmaker Novo Nordisk — a once-daily drug that shares the same brand name as its popular injection Wegovy. A GLP-1 pill from the company’s chief rival Eli Lilly isn’t far behind, with a U.S. approval expected within months. 

For some people, pills may serve as a more convenient — and potentially cheaper — alternative to today’s blockbuster injections. The cash prices of Novo Nordisk’s Wegovy pill range from $149 to $299 per month, depending on the dose, which is slightly less than the newly lowered cash prices of injections. 

While the pills aren’t expected to bring more weight loss than weekly shots, based on separate clinical trials, some health experts say expanding the range of treatments could still be a major win for patients.

Pills could attract new patients to seek obesity treatment for the first time, expanding the broader weight loss and diabetes drug market and potentially boosting sales for Novo Nordisk and Eli Lilly. The new users may include people who are afraid of needles, as well as patients who could benefit from existing injections but don’t view their condition as severe enough to warrant a weekly shot.

“I think that there are a lot of people out there who have never tried these GLP-1 drugs and are maybe waiting for the pills to come out,” said Dr. Eduardo Grunvald, medical director of the UC San Diego Health Center for Advanced Weight Management. “It’s kind of a natural preference for some people and even some prescribers.” 

“Secondly, if you have to pay out of pocket, the pills are going to be a bit less expensive than the injections, so that’s another reason,” he said. 

It’s unclear exactly how many people are currently using GLP-1s in the U.S., especially for obesity. But around 1 in 8 adults said they were taking a GLP-1 drug to lose weight or treat another chronic condition as of November, according to a poll from health policy research organization KFF.

Now, pills are emerging as the next battleground for Novo Nordisk and Eli Lilly, which established the GLP-1 space that some analysts say could be worth almost $100 billion by the 2030s. In August, Goldman Sachs analysts forecast that pills could capture roughly 24% — or about $22 billion — of the global weight-loss drug market by 2030.

Here’s how obesity pills could reshape the space.

Those users will also be able to access the starting dose of both pills for $149 per month through President Donald Trump‘s direct-to-consumer website, TrumpRx, under a deal both companies struck with his administration in November. 

Obesity injections have long been hard for patients to get, due in part to spotty insurance coverage and list prices of roughly $1,000 per month. Both Novo Nordisk and Eli Lilly have moved to address those concerns by cutting cash prices for their injectable drugs to less than half that amount.

Eli Lilly in December said the highest doses of single-dose vials of Zepbound will cost $449 per month for cash-paying patients, while Novo Nordisk in November said nearly all doses of Wegovy will cost $349 per month in cash. 

Those prices are closer to the cost of Novo Nordisk’s pill, which may still be expensive for some. But Grunvald said the roughly $150 monthly difference between the highest doses of Zepbound and Novo’s pill “could be a big difference for many people” willing to pay out of pocket.

Patients with insurance coverage for Novo Nordisk’s oral drug can pay as little as $25 per month for the treatment. But pills likely won’t move the needle to boost insurance coverage of GLP-1s for obesity in the U.S. 

The direct-to-consumer cash prices of Novo Nordisk’s oral drug are likely “significantly less” than what employers and middlemen called pharmacy benefit managers would pay to cover the drugs, said John Crable, senior vice president of Corporate Synergies, an insurance and employee benefits brokerage and consultancy.

Crable said it is unclear how much the pill will ultimately cost payers such as employers since those prices are not publicly disclosed. But if they mirror injection costs — often higher than $1,000 per month — employers may be reluctant to add the drug to their formularies, he said. 

Some companies that already offer coverage of obesity injections could add the pills this year. But Crable said some employers have actually dropped coverage of GLP-1s for obesity in 2026 due to their high costs.

“I don’t see employers being highly motivated to add what is probably going to be another high volume, very high cost drug to their formulary when the direct-to-consumer pricing for it is so much cheaper,” Crable said. 

Drugmakers have tried to make a case that patients using injections can switch easily to oral drugs. Eli Lilly in December released data showing that patients who initially took Wegovy or Zepbound shots maintained the majority of their weight loss after switching to the company’s pill. 

But Apovian, of Brigham and Women’s Hospital, said cost would be the only real reason to move patients who are doing well on injections to a pill.

“If the [cash price] is similar, I always prefer the injectables because I believe that the weight loss is better and the side effects are less,” she said.

Apovian said she wants to see real-world data on how pills perform compared with injections, but separate late-stage trials already offer some clues.

Zepbound has shown average weight loss of more than 20% in late-stage studies. That’s higher than results seen with both the Wegovy injection and pill as well as Eli Lilly’s oral drug in separate trials. 

In those same studies, about 7% of patients or less stopped treatment due to side effects from the Zepbound and Wegovy injections.

The Wegovy pill showed similar discontinuation rates, while about 10.3% of patients taking the highest dose of Eli Lilly’s oral drug stopped treatment because of side effects.

Leerink Partners analyst David Risinger said patients with obesity who need to lose a larger percentage of their body weight will likely stick with injections, unless they have a fear of needles.

Pills, he said, could primarily attract new patients who are overweight or mildly obese and want to achieve only “modest” weight loss.

Some patients currently using weekly injections may try pills, Risinger added, though not all will find a daily oral option more convenient.

That includes Karen Galante, 42, of Horsham, Pennsylvania, who is taking a compounded version of semaglutide – the active ingredient in Wegovy – which she said is priced similarly to Novo Nordisk’s new pill.

Galante said she does not plan to switch.

“It’s hard enough for me to remember to take my vitamins every day,” she said. “I like the set-it-and-forget-it of taking one shot a week.” 

There are no head-to-head studies directly comparing that pill with Eli Lilly’s. In one of Eli Lilly’s late-stage trials, the highest dose of its pill helped patients lose 12.4% of their body weight on average at 72 weeks. 

Despite that difference in efficacy, Risinger said the two pills are viewed as promoting roughly similar levels of weight loss. Some patients may also not need to take the highest dose of either pill, he added. 

In an August note, Goldman analysts said they expect Eli Lilly’s pill to have a 60% share — or roughly $13.6 billion — of the daily oral segment of the market in 2030. They expect Novo Nordisk’s oral semaglutide to have a 21% share — or around $4 billion — of that segment. The analysts said they expect the remaining 19% slice to go to other emerging pills.

Other drugmakers are racing to bring their own oral options to the market, including Pfizer, AstraZeneca, Structure Therapeutics and Viking Therapeutics. 

Risinger highlighted Structure’s daily oral GLP-1, which will enter phase three trials later this year. Shares of Structure soared more than 100% on Dec. 9 after it released midstage data showing that its pill, aleniglipron, helped patients with obesity lose more than 11% of their weight at 36 weeks, when adjusted for placebo. 

Additional trial data showed that a higher dose of the pill could deliver greater efficacy – more than 15% weight loss – surpassing the results seen with the highest dose of Eli Lilly’s orforglipron. Still, the tolerability data, or how well patients tolerated Structure’s treatment, appeared to be worse than that of Eli Lilly’s pill. 

In a release at the time, Structure CEO Raymond Stevens said the pill could be “potentially best-in-class” for an oral small-molecule GLP-1. 

Risinger said he expects that pill and another oral GLP-1 from AstraZeneca could launch as soon as late 2028. 

He said potential pills that are taken weekly, as opposed to daily, and have “compelling profiles could tilt the balance more towards orals” in the market. 

Risinger pointed to privately held Verdiva Bio, which is developing several oral peptide treatments designed to be taken once a week. That company has an ongoing phase two trial on an oral GLP-1.