Novo Nordisk ($NOVO) and Eli Lilly ($LLY) reported within a day of each other, and the market split them instantly: Lilly's shares rose, Novo's fell. The two GLP-1 giants are now telling opposite stories from the same quarter. Lilly owns the category. Novo owns the pill.
Lilly's franchise sits on top
One drug now towers over the class. Mounjaro booked roughly €8.6bn in the quarter - more than double Ozempic, and more than Zepbound and Wegovy combined. Lilly holds the top two spots; Novo's best seller, Ozempic, is now only third, dead level with Lilly's Zepbound at about €4.2bn each. The single largest product in incretins is no longer a Novo drug.
And it leads on both of the measures it publishes
On Lilly's reading, it holds about 61% of the US incretin market to Novo's 39%, and leads internationally too, 55% to 45%. The two markets got here differently. In the US, Lilly passed Novo on prescriptions in early 2025 from a near-tie. Internationally Novo was still well ahead as recently as January 2025, roughly 69% to 31% of revenue, and Lilly only drew level around the turn of this year.
Those two bars are not the same measurement, and the difference matters. The US figure is share of prescriptions; the international figure is share of revenue. Novo measures the international market by volume instead and reaches the opposite answer: its own deck claims it "continues to be GLP-1 volume leader, with 58% market share" outside the US. Both can be true at once, because Novo sells more units at lower prices. Lilly is taking the value; Novo is still moving the boxes.
Novo is losing share, much faster in the US
The clearest number in Novo's results is also the most painful. The US obesity market grew 87% year over year; Novo's US obesity sales grew 4%. Internationally it is 71% against 37%.
Those pairs are not measured the same way either, and it cuts in Novo's favour this time. The market figures count units over the twelve months to May; Novo's are revenue for the quarter, currency-adjusted, and its own filing says both regions were "partly offset by lower realised prices". Falling prices depress the revenue line without costing a single patient, so the real volume gap is narrower than 87-against-4 makes it look. The direction is not in doubt, though, and it is the same direction in both regions: Novo is losing share everywhere, just far faster at home in the US market than outside it.
But Novo won the pill
Here is where the quarter turns. Novo's Wegovy pill is running at about 265,000 US prescriptions a week, seven months after launch. The whole Wegovy franchise is around 575,000, so the pill already accounts for 46% of it, and Novo says the franchise leads the US obesity market on new-to-brand prescriptions with roughly a 60% share in July.
Novo's own read on the oral race is blunt: its head of US operations told analysts the Wegovy pill "has captured around 90% of the oral obesity medication market" since Lilly's orforglipron, branded Foundayo, launched in early April. Treat that figure gently. It comes from retail prescription data, and Lilly says it is sampling the first 30 days of Foundayo therapy, which keeps exactly those patients out of that data. Lilly publishes no weekly script count of its own, and its prescriber base went from 8,000 to 36,000 in the quarter. Novo is clearly ahead; by how much is not yet measurable.
The ramp is the fastest the category has produced: one million US prescriptions by week 12, and the most recent million added in just four weeks. Novo calls it "the strongest-ever GLP-1 launch by volume," and its head of US operations put the competitive read plainly: "Wegovy pill appears to be the oral option of choice."
The honest caveats belong here too. Orforglipron launched months later and is far earlier on its own curve; it carries no food-and-water restriction, which the Wegovy pill does; and as a small molecule its manufacturing economics still matter if the oral market turns into a price war. Round one is not the fight.
What comes next
Both companies raised full-year guidance - Lilly to $85-87bn in revenue, Novo to roughly flat-to-down on adjusted sales, up from the steeper decline it guided in the spring. The catalysts are staggered from here: Novo's CagriSema faces a US decision around Q4 2026, while Lilly's retatrutide - which delivered the largest weight-loss numbers the class has seen - has a complete clinical package and a stated target: chief scientific and product officer Dan Skovronsky told analysts Lilly plans "to submit in the U.S. in quarter one 2027 under the BLA pathway." Two things could move it. Lilly still needs more manufacturing data, and it is in litigation with the FDA over whether retatrutide counts as a biologic at all, which decides whether it files a BLA or an NDA. Dave Ricks would commit only to updating investors "as there's any progress on the filing status."
The one-line summary of Q2 2026: Lilly is winning the market, Novo won the launch, and the oral era has only just begun.