Eli Lilly Stays on Top of the Weight Loss Drug Race with a Game-Changing Pill on the Horizon

$LLY  has taken the lead in the booming weight loss drug market, and its next move could push it even further ahead—a pill that could make injections a thing of the past.

 

Zepbound or Wegovy Which Drug Really Wins

Right now, the weight loss market is dominated by two big names:

• Eli Lilly's Zepbound (generic: tirzepatide)

• Novo Nordisk's Wegovy (generic: semaglutide)

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Wegovy had a head start, but Zepbound has quickly stolen the spotlight by delivering better results. In a head-to-head trial published last December, patients taking Zepbound lost an average of 20.2% of their body weight, compared to 13.7% for Wegovy. That difference has helped Zepbound grab 60% of market share and 75% of new patient starts, despite being the newer entrant.

CVS Just Dropped Zepbound What Happened and Why It Matters

Starting this month, Caremark, the pharmacy benefit manager (PBM) owned by CVS, removed Zepbound from its list of preferred drugs and replaced it with Wegovy.

This change affects about 200,000 patients who had access to Zepbound through Caremark-managed health plans. These patients may now face higher out-of-pocket costs or be asked to switch to Wegovy.

PBMs act as middlemen between drugmakers, insurers, and pharmacies. They negotiate discounts and decide which drugs get favored placement in insurance plans. CVS says the switch was made to "enable wider, more affordable coverage"—which usually means Novo may have offered deeper discounts to secure preferred status.

Still, the impact might be more symbolic than financial. Lilly is adding around 500,000 new Zepbound patients each month, so the CVS change, while notable, affects only a small slice of the total.

How These Drugs Actually Work

Both Zepbound and Wegovy belong to a class of drugs called GLP-1 receptor agonists. These drugs mimic a natural gut hormone (GLP-1) that’s released after eating. They help regulate blood sugar, slow digestion, and increase feelings of fullness.

• Wegovy is a GLP-1 agonist.

• Zepbound goes a step further—it’s a dual agonist, targeting both GLP-1 and another hormone called GIP.

• Retatrutide, Lilly’s next-generation drug in development, is a triple agonist that adds a third gut hormone into the mix. It’s been nicknamed “Triple G.”

These drugs are all given by weekly injection, which isn’t ideal for every patient.

Lilly's New Pill Could Be a Game Changer

That’s why Eli Lilly is racing to bring a pill version to market. The new drug is called orforglipron, and it's already shown promising results in late-stage trials. While it may not be quite as effective as Zepbound, analysts expect it to perform on par with Wegovy, making it a strong contender—especially for patients who prefer not to take injections.

Crucially, orforglipron is a small molecule drug, which means it’s made from chemicals (like aspirin) rather than living cells. That makes it easier to store, ship, and manufacture at scale. Injectables like Zepbound and Wegovy are biologics, which require refrigeration and special handling.

J.P. Morgan analyst Chris Schott recently wrote that the oral format could extend patient use, open up new global markets, and boost long-term revenue potential.

Investors Are Watching Closely

Despite short-term bumps like the CVS decision, Wall Street remains bullish on Lilly.

• In 2023, Lilly doubled its earnings to just under $13 per share.

• By 2030, consensus estimates suggest earnings could surpass $55 per share.

• The stock is currently trading around $790. J.P. Morgan sees it reaching $1,100 within a year, a potential 39% upside.

At that price, Lilly would be trading at around 30x its projected 2027 earnings, so investors would be betting on continued aggressive growth—and sustained enthusiasm from the market.

A Massive Market with Big Implications

Last year, the global weight loss drug market was worth $15 billion. Morgan Stanley expects it to balloon to $150 billion by 2035, with $80 billion coming from the U.S. alone.

That kind of growth could reshape not just the pharmaceutical landscape, but also industries like packaged food, restaurants, and alcohol, as more people shift toward healthier lifestyles.

One thing is clear: Eli Lilly isn’t just betting on winning today—it’s building to dominate the next decade.