Eli Lilly and Novo Nordisk are in a global battle for dominance in the weight loss space. BioSpace takes a look at the territory covered and what’s to come.
After finally resolving the manufacturing issues that dogged the rollout of GLP-1 drugs for weight loss in the U.S., Novo Nordisk and Eli Lilly are shifting their focus to world domination.
Lilly laid down the latest gauntlet, winning approval for tirzepatide in India—a market that Leerink Partners analysts called substantial in a note to clients this week. About 18% of Indian adults are overweight, according to the World Obesity Federation. The drug will be sold not as Zepbound, the brand name when marketed for weight loss in the U.S., but by its diabetes moniker Mounjaro.
Elsewhere in the world, Novo has led on approvals and launches. While both companies’ drugs are approved for weight loss in many regions of the world, far fewer areas have actually seen the therapies become available.
Europe is a prime example. The European Medicines Agency authorized Wegovy in January 2022 and Mounjaro for weight management in June 2024. So far, Wegovy has launched in France, Germany, Norway, Spain, Italy, Switzerland, Iceland and Novo’s home country of Denmark. The drug is also available in the U.K. Zepbound, meanwhile, can only be found in Poland.
Both companies have been duking it out in China for at least a few months. Wegovy started flowing in the region in November 2024, while Lilly conducted a limited launch there in 2024 and has plans to ramp up in the country.
Wegovy has by far the biggest global footprint, with launches underway in Brazil, Australia, the United Arab Emirates, Japan and Canada.
India is an interesting market, with drugs typically selling for well below half of U.S. net pricing, Leerink said. Lilly has priced the weight loss drug at $200 for a month supply. This compares to $483 for the drug in China and a U.S. list price of about $1,087.37 per fill (several direct-to-consumer cost savings programs that can bring the price down to about $650 per month for U.S. self-pay customers).
Combining the opportunities in China and India, Leerink estimates there are 718 million addressable patients.
Novo has targeted an India launch in 2026, giving Lilly a full year of momentum. Lilly, meanwhile, has plans to launch tirzepatide in Brazil and Mexico, with more revenue coming from those regions, plus China and India,beginning in the second half of this year and into 2026, Leerink noted.
During a fourth-quarter earnings call, Lilly CEO David Ricks noted that the company is “still gating promotion and gating launches globally” due to supply constraints.
