Patients on Eli Lilly & Co.’s experimental diabetes pill lost more weight and had better blood sugar control than those on an older, approved rival from Novo Nordisk A/S in the first head-to-head trial of the two medicines.
The highest dose of Lilly’s pill — called orforglipron — led to a 1.9% drop in blood sugar levels and shaved roughly 18 pounds from patients’ frames, significantly more than those getting Novo’s Rybelsus. The initial findings from the Lilly-funded study came as the Indianapolis-based drugmaker released full data about orforglipron’s impact on obesity at the European Association for the Study of Diabetes meeting.
The results will help Lilly take the lead in the emerging market for an oral form of the GLP-1 drugs that have surged to blockbuster status in recent years, analysts said. Orforglipron, plus a more potent, experimental version of Novo’s GLP-1 pill, is expected to help drive future demand for a class of medicines that’s become so popular that companies have struggled to maintain enough supply.
The study findings “clearly position orforglipron as the preferred oral agent” for patients with type 2 diabetes, Evan David Seigerman, an analyst for BMO Capital Markets, wrote in a note to clients. While blood sugar control is important for diabetic patients, “we believe this clear differentiation on weight loss efficacy will be meaningful for endocrinologists,” he said.
Lilly shares rose as much as 1.6% in New York Wednesday, while Novo rose as much as 3.8% in Copenhagen.
Doctors at the meeting welcomed the results, saying the pill will make it possible to treat more patients because it’s easier to produce and to take, and may eventually be cheaper. Lilly officials pledged to get the medicine to market as quickly as possible.
“It’s probably one of the most important medicines we’ve ever launched from a global health perspective,” Lilly Chief Scientific Officer Dan Skovronsky said in an interview with Bloomberg TV. “We’ll do everything we can to make sure that the burden on patients is as low as possible in every way possible, including economic burden for patients.”
Lilly and Novo have been locked in a fierce battle to control the obesity market, which is projected to reach $100 billion by the end of the decade, according to Bloomberg Intelligence. Both companies have highly effective shots on the market, but pills are seen as the key to reaching more patients.
The latest study was designed to compare how well the two pills controlled blood sugar in patients with diabetes, but it also looked at weight loss. It enrolled about 1,700 patients whose blood sugar levels were not adequately controlled with metformin, a common diabetes treatment.
Patients on the highest dose of orforglipron had a 1.9% drop in blood sugar levels, compared with a 1.5% reduction with Novo’s drug Rybelsus, Lilly said in a statement. Patients given orforglipron lost 8.2% of their body weight — roughly 18 pounds — in 52 weeks, while those on Novo’s drug lost 5.3% of their body weight — about 12 pounds.
Side effects in the study were mostly stomach-related. More patients stopped taking Lilly’s pill due to side effects than Novo’s, though Lilly cautioned the study was not powered to compare the two drugs’ tolerability.
“These results, combined with orforglipron’s once-daily oral dosing and broad scalability, reinforce its potential as a foundational treatment for type 2 diabetes,” Kenneth Custer, executive vice president Lilly Cardiometabolic Health, said in a statement.
Lilly has said it plans to ask regulators to approve the drug as a diabetes treatment in 2026.
In the meantime, Lilly is moving quickly to get its pill approved as a treatment for obesity, which is seen as a more lucrative market. It expects regulators to make a decision on whether or not to approve the treatment for weight loss early next year.
Both pills are taken daily, but there are some key differences between the two. Novo’s pill has some restrictions around food and water intake, while Lilly’s does not. Orforglipron is also a small molecule drug, meaning it’s relatively easy to manufacture compared to shots. Novo’s pill, on the other hand, is a peptide made from the same ingredient as its best-selling drugs Ozempic and Wegovy.
