Can Novo Nordisk Unseat Eli Lilly as the Weight Loss Drug Leader in 2026?

Novo Nordisk (NYSE: NVO) was once the top player in the weight loss drug market. The company's medicine, Wegovy, practically became a household name. However, it has lost the top spot to its eternal rival, Eli Lilly (NYSE: LLY).

Novo Nordisk hasn't had the last word, though, and it is now working hard to regain its lead in this fast-growing space. Can it pull it off this year? Let's find out.

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Novo Nordisk's best shot

Novo Nordisk recently got an important win that could help it regain market share. An oral version of Wegovy has now earned the green light in the U.S.

Oral Wegovy could attract significantly more patients. Here are three reasons why.

First, it's essential to consider price factors. Patients will likely pay between $149 and $299 out of pocket per month for oral Wegovy. Zepbound -- marketed by Eli Lilly -- costs as much as $1,000, although many, even without insurance, end up paying far less.

Still, Novo Nordisk's new launch will almost certainly be less expensive, on average. At a lower price, many people will accept a lower (but still competitive) efficacy.

Second, many will also opt for oral pills over needles. Third, since pills are easier to manufacture, Novo Nordisk could reach a far greater number of patients with oral Wegovy.

If all goes well, the company could succeed in expanding the market altogether and capturing a bigger slice of it, potentially regaining the lead from Eli Lilly.

It might not be enough

Eli Lilly also seems to be close to earning approval for its own oral weight loss medicine, orforglipron. It aced phase 3 studies across obesity and weight management last year. What's more, orforglipron earned a new voucher from the U.S. Food and Drug Administration (FDA) that will allow for a much shorter review time -- one to two months versus the usual 10 to 12 months.

Having submitted an application to the FDA for orforglipron late last year, we can expect Eli Lilly to earn approval for it by the end of February, unless there is a problem with the data, or it encounters another unforeseen setback, which seems somewhat unlikely. Once Eli Lilly launches orforglipron, it will likely set a price tag that somewhat rivals Novo Nordisk's Wegovy.

Meanwhile, the original formulation of Wegovy will continue having trouble keeping pace with Zepbound. In other words, investors shouldn't bet on Novo Nordisk catching up to Eli Lilly this year.

Is the stock a buy?

Even if that's the case, there is a compelling case to be made for Novo Nordisk. Beyond oral Wegovy, it has earned other label expansions in recent months and is racing toward the approval of its next-gen anti-obesity medicine, CagriSema. The Denmark-based pharmaceutical giant also has other important mid- and late-stage candidates that are expected to make progress in the coming years.

In my view, Novo Nordisk remains a buy.

Prosper Junior Bakiny has positions in Eli Lilly and Novo Nordisk. The Motley Fool recommends Novo Nordisk. The Motley Fool has a disclosure policy.