• 15 Aug, 2025
• Dr. Mahdi Khazaei

Weight-Loss Pills Are Coming. What It Means for Investors

The investment case starts with convenience. Injections built a huge market, yet a weekly shot is still a hurdle for some people. A daily tablet removes that friction. Pills are easier to ship and store, which matters when a category scales into the tens of millions of prescriptions. As Reuters reported, several companies are racing for the finish line, and the market for weight-loss medicines could top 150 billion US dollars early in the next decade. Many of the new candidates are small molecules rather than peptides, so manufacturing looks more like traditional pills than sterile injectables. That can lower unit costs over time and smooth out supply, two points investors care about when modelling margins and capacity.

The near-term catalyst is Novo Nordisk’s application for an oral version of Wegovy after the US FDA accepted the filing in May, with a decision window in the fourth quarter of 2025. Novo has reported around 15 percent average weight loss with once-daily oral semaglutide at the highest dose in trials, which would be competitive with many injectable regimens if that number holds up in the real world. A green light would give prescribers an easy on-ramp for patients who are needle shy. It would also give pharmacies a product that fits into existing pill workflows rather than the cold chain injectables require.

Eli Lilly, Novo’s main rival, moved the story forward with phase 3 results for its pill orforglipron. The company said the study met its main goals, with average weight loss of about 12 percent over 72 weeks. Market reaction was mixed since investors had hoped for numbers closer to the best injectables. For the business, the message is still significant. A viable daily pill gives Lilly a second engine alongside its fast-growing injectables, and the company raised full-year guidance, a reminder that demand remains strong even as the product mix starts to change.

The field is getting crowded. Structure Therapeutics is pushing a small molecule called aleniglipron through late-stage testing, with more data expected by year end. Roche has an oral candidate from the Carmot acquisition that showed meaningful early weight loss and is now moving through mid-stage trials. AstraZeneca and Eccogene have another oral GLP-1 in phase 1b work in China. Viking Therapeutics is testing both an injectable and an oral version of its dual agonist, giving it two shots on goal across different price points and patient preferences. More players mean more negotiating power for insurers, more choice for doctors, and more potential for price tiers that look like other big primary care drug classes. For investors, it also means more catalysts and more volatility as data and regulatory dates hit the tape.

Pricing and access will decide who wins the profit share. Payers tolerated high prices for the first wave because savings on complications can be large. Pills could push that debate in two directions at once. On one hand, scale and simpler manufacturing may pull prices down, which expands the market and can still grow revenue if volume jumps. On the other hand, more competitors give pharmacy benefit managers room to push for steeper rebates and tighter formularies. Expect step therapy rules that nudge new patients toward a preferred pill first, with injectables reserved for those who need the biggest effect or who cannot tolerate a tablet. Those dynamics echo cholesterol and blood pressure markets, which settled into multi-tier pricing with room for several brands.

Supply and logistics are another lever. Companies spent the past two years racing to add sterile filling lines and cold storage for injections. Pills shift the bottleneck to chemical synthesis and tableting capacity, which is far more common in the industry. That does not guarantee a smooth launch, but it lowers the risk of empty shelves that frustrate patients and dent brand loyalty. Pharmacies also prefer pills because they move through existing inventory systems, require less pharmacist time per script, and keep more refill traffic in store. If pills take off, expect more retail partnerships, direct-to-employer contracts, and digital refills that create stickier customer relationships across the chain.

Investors should watch side effects and adherence. Nausea and other gastrointestinal issues have been the main reason people stop therapy, and daily pills could push adherence in either direction. Some patients will prefer taking a tablet with breakfast. Others may find a weekly shot easier to remember. Real-world persistence will feed back into revenue forecasts and may influence payer coverage rules. Safety will remain under the microscope until millions of patient years of data accumulate. That is standard for a mass market class, but any surprise in the label can swing share quickly.

Earnings momentum suggests the category still has room to run, even as expectations reset week by week. Lilly’s latest results showed a large revenue jump on injectables, and Novo posted double-digit growth for the first half while cautioning about costs and competition. Big cash flows give both companies room to price with strategy, invest in more capacity, and fund new indications. Those same cash flows also fund deal-making, so do not be surprised if smaller pill makers become targets before the first approvals arrive.

The simple version is this. Pills will not replace shots overnight, and the best injectables may remain the gold standard for fast and deep weight loss. Daily tablets can grow the pie, smooth logistics, and give insurers a cheaper option that still moves the needle on outcomes. That mix is good for patients who want choice, and it can be good for investors who build a diversified position across leaders and promising entrants. The next twelve months will bring decisions, more data, and likely a few deals. By this time next year, the weight-loss market may feel less like a two-horse race and more like an entire league.

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