Wegovy pill market share claim hinges on scripts IQVIA cannot see

Novo Nordisk says its Wegovy pill market share is far larger than rival figures suggest. On its third quarter call on 4 November, chief executive Mike Doustdar said the oral semaglutide tablet holds about 80 percent of the US oral GLP 1 obesity market, with 20 percent left for Eli Lilly's Foundayo. Lilly had said the week before that Foundayo won 40 percent of new patient starts since its launch. The gap comes down to which prescriptions each company can see, and no independent party has checked either number.

What Novo claimed on its third quarter call

According to the BioSpace account of the call, Doustdar said the Wegovy pill has reached 8 million cumulative US prescriptions since its January launch. He called it "the strongest pharma launch by volume in the U.S. in the last decade." He then set out the split he believes is real: 80 percent of the oral market for Novo and 20 percent for Lilly. He also said that 80 percent of people starting the pill are new to obesity treatment, which, if it holds, means the tablet is reaching people that weekly injections did not. Novo has not published the patient level data behind that claim, so readers should treat it as a company statement rather than a measured result.

The written report is more modest. In Novo's financial report for the period, the company says the Wegovy franchise, pill and injection together, keeps US leadership in new patient starts with more than 50 percent of the branded obesity market. It puts third quarter sales of the pill at DKK 5,394 million and lists launches in the US, the UAE, the UK and Germany by the end of September, with four more countries since then. Neither the 80 percent figure nor the 8 million prescription count appears in that release. Both came from the earnings call, where they were spoken by management rather than set out in the reported accounts, and no breakdown by channel or week was given.

Why IQVIA prescription data split the count

The dispute over Wegovy pill market share rests on IQVIA prescription data, the outside panel that Lilly cited. Doustdar said Lilly's finance chief had pointed to IQVIA, which in his words "covers 90 to 95% of their scripts and only 65% of our scripts." The missing share, he argued, runs through telehealth partners such as Hims & Hers and Ro. "Those companies do not share their data with IQVIA," he said, adding that full reporting would bring outside counts up to Novo's own. Lilly has not, in the material we reviewed, answered the coverage point directly. The claim is plausible in outline, since direct to consumer channels can sit outside retail pharmacy panels, but Novo did not show how it measured them.

Applying the CEO's own coverage figures to Lilly's split gives the Wegovy pill roughly 68 percent of starts, not 80 percent.

A simple check shows the two claims do not line up neatly. If IQVIA sees 60 percent of starts going to Novo and 40 percent to Lilly, and captures 65 percent of Novo scripts against 90 to 95 percent of Lilly scripts, scaling each side back up is straightforward arithmetic. Applying the CEO's own coverage figures to Lilly's split gives the Wegovy pill roughly 68 percent of starts, not 80 percent. That is our calculation, not a company figure. The remaining gap suggests the two numbers measure different things, such as total prescriptions against new starts, or different time windows. Until either company states its method, the safest reading is that both data sets put Novo ahead, by a margin nobody outside can confirm.

Foundayo and the oral GLP 1 race

The two tablets reach the same receptor by different routes. The Wegovy pill is oral semaglutide, the same peptide sold as a weekly injection, while Foundayo is orforglipron, a non peptide small molecule that Lilly brought to the US market in the second quarter. Lilly has acknowledged that launching a wholly new drug left it at a slight disadvantage against a molecule doctors already know, BioSpace reported. Doustdar leaned on that point, citing the pill label, its weight loss data and familiarity with semaglutide. Lilly's own quarter showed the cost of a slower start, with a Foundayo revenue miss against analyst forecasts even as its sales grew. For a peptide tablet, holding its lead over a small molecule rival is the test that matters.

Scale still favours Lilly overall. The company reported third quarter revenue of $24.4 billion, and chief executive David Ricks highlighted a 39 percent rise driven by demand for weight loss medicines. Novo's group net sales for the same period were DKK 79,195 million. The oral GLP 1 race is therefore a contest inside a much larger market that Lilly leads on injections. Both chief executives framed it as early. "This is still at early innings," Doustdar said, adding that many people in need have not yet been treated. That framing matters for the share fight, because a market that keeps adding new patients can let both tablets grow even while one of them loses relative ground, which makes early share numbers a weak guide to the final outcome.

What the Novo Nordisk third quarter report confirms

The verified numbers come from the company's report. Net sales rose 6 percent in kroner and 4 percent at constant exchange rates, and adjusted operating profit reached DKK 31,720 million, up 27 percent at constant rates against a quarter last year that carried heavy restructuring costs. Novo raised its full year outlook and now expects adjusted sales growth between minus 2 and plus 2 percent at constant rates, citing higher expectations for GLP 1 products. Our earlier story on third quarter pill sales covers how the tablet compared with analyst forecasts. BioSpace reported that Novo shares rose more than 6 percent before the US open on the day, though the stock remained down 21 percent for the year.

Several things remain unknown. Neither company has published an audited Wegovy pill market share among new oral starts, and Novo has not said how many scripts flow through telehealth partners. Eight million prescriptions is a count of scripts, not of people, and it says nothing about how many patients stay on treatment after the first months. Persistence will decide revenue more than launch volume. Outside panels will keep tracking the parts of the market they can see, as in our recent look at weekly US script counts, and those counts carry the same blind spot Doustdar described. The fourth quarter reports from both companies, expected early in 2027, are the next point where either side can back its claim with disclosed method.

Conclusion

Novo's Wegovy pill market share claim of 80 percent and Lilly's 40 percent figure for Foundayo both rest on data the other side disputes or cannot see. On either count, oral semaglutide leads the US tablet race, and the stage stays approved. The size of that lead depends on telehealth volumes that Novo has described but not disclosed. Until both companies publish their methods, readers should treat each number as a company claim, not a market fact.