Analysts at Jefferies estimate Foundayo's revenue could climb as high as $1.6 billion this year.
With a second oral GLP-1 for obesity now approved in the U.S., analysts have set to work parsing the blockbuster potential of Eli Lilly’s Foundayo in 2026, as well as the dynamics at play with Novo Nordisk’s equally buzzy Wegovy pill, which launched with a three-month head start on Lilly’s drug in January. Meanwhile, Novo—apparently intent to keep hold of its first mover advantage in the obesity pill space—is mounting a proactive defense focused on the company’s assertions of “significantly greater” weight loss on oral Wegovy versus Foundayo. With the FDA’s approval of Foundayo (orforglipron) Wednesday, Lilly has said it is now taking prescriptions for the oral medication on its LillyDirect cash pay channel, with shipments slated to begin next week. That gives Foundayo some nine months to lay down commercial roots in 2026. Analysts at Jefferies figure that Foundayo's revenue figure could climb as high as $1.6 billion this year, caveating in a note to clients Wednesday that Lilly’s new oral option is unlikely to supplant the company’s injectable obesity mainstay Zepbound (tirzepatide) overall, urging investors to “be more focused on [the] total size of the obesity market.” Framed another way, for Foundayo to reach a consensus sales estimate of $1.7 billion this year, Lilly would need to generate roughly 5.4 million prescriptions from April through December, according to an April 1 note from UBS. To hit roughly $2 billion in sales during its launch year, Foundayo would need to generate around 6 million prescriptions, the UBS team said, adding that they believe a patient tally of 5 million to 6 million scripts in 2026 is “doable,” especially in light of sustained “strong demand” for Novo’s Wegovy pill. Putting that target into context, Lilly’s dual GIP/GLP-1 obesity med Zepbound (tirzepatide), which is injected, charted around 6.4 million prescriptions in 2024, the first full year of its launch, with 4 million of those patient referrals coming during the med’s first nine months on the market, the UBS analysts noted.Lilly also figures that access, awareness and direct-to-patient channels are in a much better place to support Foundayo’s launch now than when Zepbound debuted, according to UBS’ report. Catching up to Novo Novo’s Wegovy pill, which was approved late last year and launched on Jan. 5, has secured a strong head start in the obesity market’s newly opened oral front. In the first two weeks of its U.S. launch, Novo’s pill, with around 20,000 prescriptions, managed to outpace both injectable Wegovy (roughly 1,600 prescriptions) and Zepbound (some 7,300 prescriptions) over that same time span during their respective rollouts, Jefferies noted at the time. Meanwhile, Foundayo may offer certain perks that allow it to eke out an edge over the Wegovy pill, despite its slightly later arrival on the market, industry watchers have pointed out. For one, Foundayo has no food restrictions, unlike oral Wegovy, which must be taken on an empty stomach and with up to 4 ounces of water, followed by a 30-minute fasting period, according to a Wednesday note from William Blair. With that in mind, William Blair analysts “expect Foundayo to blunt the uptake of oral Wegovy upon its availability.” Nevertheless, Novo’s pill may retain a pricing advantage, the William Blair team and other analysts pointed out. While starting prices for the two drugs are largely similar, the highest dose of Foundayo will land at $349 per month for cash-paying patients, versus $299 per month in the same channels for the Wegovy pill, according to UBS. That said, Lilly will offer the highest 14.5 mg and 17.2 mg doses of Foundayo to cash-paying patients for $299 per month if they refill their prescriptions within 45 days, per Jefferies. The UBS team, meanwhile, added that they expect cash-pay platforms like Lilly Direct to become “the largest channel in the initial days of the launch,” prior to Medicare and commercial insurance coverage for Foundayo comes online this summer. The wholesale acquisition cost (WAC) for Foundayo, which represents the medicine’s list price before any discounts through insurance or other channels, is landing at $649 per month, Lilly told Jefferies this week. For its part, Novo seems eager to bring the heat to Lilly and its new obesity pill early. On Thursday, the Danish drugmaker teased an upcoming data drop, scheduled for the upcoming Obesity Medicine Association annual conference in San Diego, showing that the 25-mg Wegovy pill was “associated with significantly greater mean weight loss than orforglipron 36 mg in a population-adjusted indirect treatment comparison.” Patients also showed a “greater preference” for an “oral semaglutide-like profile than an orforglipron-like profile” in a separate patient preference study, according to Novo. “These studies add to the growing body of evidence supporting the clinical strength of semaglutide and highlight attributes that patients value when choosing an obesity medicine that fits their lifestyle,” Jamey Millar, EVP of U.S. operations at Novo, said in a statement Thursday. “People often ask how one medication compares to another when making obesity treatment management decisions,” Robert F. Kushner, M.D., of the Northwestern Feinberg School of Medicine, continued in Novo’s release. “Since there are no head-to-head trials comparing oral semaglutide for obesity to orforglipron, this indirect treatment comparison from the Orion study provides important information that can be used during the shared decision-making process.”As the competitive dynamics begin to play out between Foundayo and the Wegovy pill, analysts remained largely aligned on the fact that Lilly’s and Novo’s new oral options are unlikely to supplant the companies’ respective obesity injectables Zepbound and Wegovy. Overall, those injectable drugs are likely to keep hold of a roughly 80% share of the U.S. branded obesity market, according to the William Blair analysts, which the team credited to the “high potency of injectables” and a “more elevated U.S. [body mass index] population.” Nevertheless, the rapid launch of the Wegovy pill has shown that many patients new to GLP-1s are trying an oral option, with the William Blair team suggesting that Novo’s and Lilly’s launches could help expand the total addressable market for obesity treatments more broadly. What’s more, the high-single-digit placebo-adjusted weight loss reported for Foundayo could be especially appealing to the roughly 32% of the U.S. adult population that is classified as overweight but does not have obesity, they added.