Eli Lilly, Novo Nordisk sold more than $40 billion in GLP-1 drugs in 2024

For Eli Lilly and Novo Nordisk, the present and future are about weight-loss drugs.

The two companies dominate the market for GLP-1 drugs, which are prescribed for diabetes and obesity. Eli Lilly’s Mounjaro and Zepbound as well as Novo Nordisk’s Ozempic and Wegovy have collectively raked in more than $40 billion in sales.

“The story continues to be about market expansion for obesity,” David Moore, president of Novo Nordisk’s US business, told analysts on Wednesday morning.

Novo Nordisk’s drugs entered the market earlier than Eli Lilly’s. Appetite for Ozempic, which is prescribed for diabetes, appears to have moderated, while Wegovy demand is still growing. They currently have the larger market share, but Eli Lilly’s newer drugs might have more room to grow.

Sales of Mounjaro, which is also prescribed for diabetes, doubled between 2023 and 2024, and sales of Zepbound increased by 2,684% during the same period. “We believe both products are still very early in their launch cycle,” Eli Lilly CEO David Ricks told analysts on Thursday.

The types of ailments that GLP-1s can be prescribed for are also growing, with Zepbound recently getting approval from the FDA to treat sleep apnea. Some early studies have also shown that it may be able to treat alcoholism.

Oral GLP-1 drugs, which would entice consumers not keen on jabbing themselves each week, are the next frontier. Novo Nordisk already has a once-daily pill on the market, Rybelsus.

But being able to keep up with demand for drugs currently on the market might be their biggest challenge. The boom in popularity of GLP-1 drugs has led to manufacturing bottlenecks, which has made way for compounding pharmacies to eat at their market share.

The FDA declared a shortage of tirzepatide, the active ingredient in Mounjaro and Zepbound, in December 2022, and didn’t take it off the shortage list until December 2024. During that period, Eli Lilly reported spending more than $10 billion in capital expenditures, much of which went to expanding manufacturing.

“From a manufacturing standpoint, I really wouldn’t want to be anyone other than Lilly or Novo at this point,” Mizuho Healthcare equity strategist Jared Holz told Yahoo Finance. “When you consider how much they’ve invested behind capex and the supply chain logistics, it’s been overwhelming.”

Semaglutide, the active ingredient in Novo Nordisk’s Ozempic and Wegovy, remains on the FDA’s shortage list. This allows compound versions of the drug to be sold by online pharmacies like Hims & Hers.

The company said it expects supply improvements in 2025. “We are focused on doing that as fast as possible as we believe this will help our further actions to curtail compounding in the future,” Novo Nordisk’s Moore told analysts. ​

Outsourcing Facilities Association, a trade organization representing compounding pharmacies like Hims & Hers, has previously sued the FDA to try to keep tirzepatide on the shortage list. They may soon have a more sympathetic leader at the helm of that agency: President Trump nominated Marty Makary, who is currently chief medical officer of compounding pharmacy Sesame, to lead the FDA.