Eli Lilly Is Dominating the GLP-1 Wars as Novo Nordisk Sales Tank

Core Insights - The competition in the GLP-1 market has intensified between Eli Lilly and Novo Nordisk following their recent fourth-quarter earnings reports [1] Eli Lilly's Performance - Eli Lilly has gained market leadership with its tirzepatide drugs, Mounjaro and Zepbound, which show superior weight loss efficacy of around 20% compared to semaglutide's 14% [2] - In the fourth quarter, Eli Lilly's revenue increased by 43% to $19.3 billion, surpassing consensus estimates of $17.9 billion, driven by a 46% volume growth despite a 5% decline in realized prices [7] - Mounjaro sales surged 110% to $7.4 billion, exceeding the forecast of $6.7 billion, while Zepbound revenue increased by 123% to $4.3 billion [8] - For 2026, Eli Lilly projects revenue growth of 27% to between $80 billion and $83 billion, above the consensus of $77.6 billion, with adjusted earnings expected to be between $33.50 and $35.00 per share [8] Novo Nordisk's Challenges - Novo Nordisk initially dominated the GLP-1 market but is now facing challenges, including a projected sales decline of 5% to 13% in 2026 at constant exchange rates, marking its first sales drop since 2017 [3][5] - The company reported 10% sales growth for 2025 at constant exchange rates, totaling 309 billion Danish kroner, which fell short of analysts' expectations of 347 billion kroner [4] - The fourth quarter showed an 8% revenue decline, although it slightly beat expectations, while earnings per share missed forecasts [4] - CEO Mike Doustdar cited U.S. pricing discounts, upcoming patent expirations for semaglutide, and competition from Lilly's Zepbound as reasons for the shortfall [5] Market Dynamics - Both companies face common challenges such as pricing pressures, competition, and patent risks, but their trajectories are diverging significantly [9] - Eli Lilly's pipeline, including the anticipated approval of orforglipron in Q2, positions it for sustained strength in the market [10] - Novo Nordisk is attempting to counteract pricing pressures with the launch of an oral version of Wegovy, which has shown early signs of success [6]