Pharma Giants Bet on Next-Generation GLP-1 Treatments to Sustain Growth
Novo Nordisk (NYSE: NVO) and Eli Lilly (NYSE: LLY) are leading the charge in the rapidly expanding diabetes and obesity treatment market, driven by the runaway success of their second-generation GLP-1 (glucagon-like peptide-1) receptor agonists. Novo Nordisk has built its franchise around Ozempic and Wegovy, while Eli Lilly has achieved rapid success with Mounjaro and Zepbound.
A new phase of competition is emerging as both companies push ahead with late-stage trials of next-generation GLP-1 drugs, including Novo’s CagriSema and Eli Lilly’s Orforglipron. These drugs could reshape the competitive landscape and drive further market expansion.
The Current Landscape
The GLP-1 market is effectively a duopoly, with Novo Nordisk and Eli Lilly controlling the five top-selling drugs: Ozempic, Rybelsus, Wegovy from Novo, and Mounjaro, and Zepbound from Eli Lilly.
- Ozempic and its oral counterpart Rybelsus are semaglutide-based treatments for type 2 diabetes, while Wegovy—a higher-dose version of Ozempic—is used for obesity or weight management.
- Mounjaro and Zepbound are tirzepatide-based drugs, targeting both type 2 diabetes and obesity, respectively.
According to Visible Alpha consensus, combined revenues from these second-generation GLP-1 drugs are expected to grow from an estimated $69.1 billion in 2025 to nearly $91 billion by 2035.
This surge stands in stark contrast to the earlier generation of GLP-1 drugs, such as Novo’s Victoza and Saxenda and Lilly’s Trulicity, which delivered modest results but are now in decline. Their limited success was attributed to inferior dosing frequency, weaker blood glucose control, and subpar cardiovascular benefits.
Diabetes Market: The Rise of Blockbuster Therapies
Novo Nordisk’s Ozempic, approved by the U.S. FDA in 2017 for type 2 diabetes, has become the company’s flagship product. Revenues grew from $270 million in 2018 to $16.7 billion in 2024, with sales expected to reach $21 billion in 2025 and peak at $25 billion by 2028 before facing patent expiry in 2032.
Rybelsus, the oral version of Ozempic is projected to see sales reach $4.2 billion in 2025, with peak sales of $6.2 billion by 2031. In contrast, sales of Novo’s older injectable drug Victoza, which peaked in 2016, are expected to decline to $624 million in 2025 as the market shifts toward newer treatments.
Eli Lilly’s Mounjaro, on the other hand, has also seen explosive growth. Approved in 2022, it generated $483 million in its first year before surging to $11.5 billion in 2024. Analysts expect Mounjaro’s sales to reach $18 billion in 2025—a +56% increase year-over-year— solidifying its position as a key asset of Lilly’s diabetes portfolio.
Obesity Market: Wegovy vs. Zepbound
Novo Nordisk’s Wegovy, approved in 2021, saw sales surge from $212 million in its first year to $8.1 billion in 2024. Sales are expected to jump +65% year-over-year to $13.8 billion in 2025, with peak sales of $22.8 billion in 2029 before patent expiration in 2032.
Eli Lilly’s Zepbound gained FDA approval in late 2023 and posted $176 million in revenue within its first few months. Sales are expected to climb to $11.8 billion in 2025 and could peak at $29 billion by 2033, positioning Zepbound as a serious competitor to Wegovy.
Next Wave of GLP-1 Treatments
Novo and Lilly are now racing to bring the next-generation GLP-1 drugs to market, aiming to build on the success of their current portfolios. These include Novo’s CagriSema (GLP-1 receptor agonist + amylin receptor agonist) and Eli Lilly’s Orfoglipiron (oral GLP-1 receptor agonist) and retatrutide (GLP-1 receptor agonist + GIP receptor agonist + glucagon receptor agonist).
Novo Nordisk: CagriSema
Novo’s CagriSema combines semaglutide with cagrilintide (an amylin receptor agonist) to improve blood glucose control and reduce gastric emptying. Although the recent Phase III results were weaker than expected, Novo plans to seek regulatory approval in early 2026.
Analysts forecast CagriSema could generate $888million in 2026, surging to $22 billion by 2035, contributing 25% of Novo’s total revenue—up from just 2% in 2026. CagriSema’s probability of success (POS) is estimated at 82% for obesity and 79% for diabetes.
Eli Lilly: Orforglipron and Retatrutide
Eli Lilly’s Orforglipron, an oral GLP-1, could solve a key challenge in the segment — supply constraints and patient adherence. Trial results are expected in mid-2025, with regulatory approval anticipated in 2026. Analysts project sales of $699 million in 2026, climbing to $19 billion by 2035—representing 15% of Eli Lilly’s total revenue. Orforglipron’s probability of success (POS) is pegged at 88%.
Lilly is also developing Retatrutide, a triple-action drug targeting GLP-1, GIP (glucose-dependent insulinotropic polypeptide), and glucagon receptors. If approved, it could offer enhanced weight loss and metabolic benefits, potentially raising the competitive stakes further.
Who Holds the Edge?
The diabetes and obesity drug market is poised for sustained growth, with Novo Nordisk and Eli Lilly leading the charge. The next generation of GLP-1 treatments could unlock new market opportunities and intensify competition, as both companies seek to extend their dominance beyond 2035.
Novo Nordisk and Eli Lilly are on track to dominate the diabetes and obesity markets through 2035 — but their strategies differ.
Novo is betting heavily on next-generation innovation to counteract the eventual decline of Ozempic and Wegovy. Meanwhile, Eli Lilly appears to have a more balanced and diversified revenue base, with strength in diabetes and obesity supported by robust sales from drugs in other therapeutic areas.
In 2025, Novo Nordisk is expected to generate $47.9 billion in risk-adjusted sales from diabetes and obesity drugs, while Eli Lilly is projected to bring in $41.8 billion. By 2035, revenues are forecast to rise to $77.5 billion for Novo Nordisk and $83.5 billion for Eli Lilly.
The battle for GLP-1 dominance is far from over — and the next wave of treatments could decide who pulls ahead in the long run.
