Stock Markets August 5, 2026 11:58 AM

Novo Nordisk and Eli Lilly Clash Over the GLP-1 Prize After Q2 Results

Q2 prints show Lilly's revenue scale and Novo's valuation gap as oral Wegovy reaches 5 million U.S. prescriptions

By Derek Hwang
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Eli Lilly reported $22.97 billion in Q2 revenue while Novo Nordisk posted a 21.9% EPS beat and its oral Wegovy pill surpassed 5 million U.S. prescriptions. The two companies are intensifying competition for the obesity market, with differences emerging in drug formats, market share, valuations, and near-term risks.

Novo Nordisk and Eli Lilly Clash Over the GLP-1 Prize After Q2 Results
NVO LLY
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Key Points

  • Eli Lilly posted $22.97B in Q2 revenue while Novo Nordisk reported a 21.9% EPS beat and oral Wegovy surpassed 5 million U.S. prescriptions.
  • Lilly leads in injectable prescription volume and pipeline scale, while Novo holds the lead in the oral GLP-1 format and presents a lower valuation multiple.
  • Sectors impacted include pharmaceuticals and healthcare delivery, with program access (Medicare GLP-1 Bridge) influencing patient uptake and market dynamics.

Two of the largest pharmaceutical companies in the obesity treatment space released second-quarter results on Aug 5, delivering contrasting headlines that underscore how differently investors can view scale versus valuation.


Q2 snapshot - Both companies disclosed quarterly results this morning. The following table outlines the key metrics observers are watching:

Metric Novo Nordisk (NVO) Eli Lilly (LLY)
Q2 Revenue $12.1B (+10.6% vs est.) $22.97B (+11.7% vs est.)
Q2 EPS Beat / Miss +21.9% beat -5.2% miss (R&D charges)
Key Drug Revenue Obesity care +16% Mounjaro + Zepbound: $14.9B
FY Guidance Raised (0% to -6% CER) Raised to $85 67B
Price today $45.18 (+2.02%) $1,148.04 (+2.97%)

The weight-loss drug battleground - The companies' product lines and clinical profiles define the competitive landscape. The table below captures reported efficacy, format, and status for the headline compounds mentioned in the results and accompanying commentary.

Drug Company Mechanism Weight Loss Status
Zepbound (tirzepatide) LLY GLP-1 + GIP ~22% / 72 wks Dominant injectable
Wegovy (semaglutide) NVO GLP-1 ~15% / 68 wks Injectable + oral
Oral Wegovy pill NVO GLP-1 ~14% / 64 wks 5M+ U.S. prescriptions, record launch
Foundayo (oral) LLY GLP-1 ~11% / 72 wks 36K prescribers
Retatrutide LLY GLP-1 + GIP + Glucagon ~22.6% Phase 3, FDA filing Q1 2027

Lilly's retatrutide, a triple-hormone agonist, delivered positive Phase 3 data showing 22.6% weight loss in patients with severe obesity and has early-access availability open. If regulators approve the filing targeted for Q1 2027, the program could leapfrog current treatments according to the clinical data disclosed.

On the oral front, Novo Nordisk is reporting strong traction: oral Wegovy exceeded 5 million U.S. prescriptions and added 1 million prescriptions in a four-week span during its launch. In the oral GLP-1 format, Novo is ahead of Lilly's Foundayo in efficacy and volume.


Market share and access dynamics - Current prescription volumes favor Lilly in injectables: Zepbound injectable scripts exceed Wegovy's weekly U.S. volume by more than two times. Novo spent much of 2025 on the defensive, implementing guidance reductions, replacing its CEO, and cutting about 9,000 jobs.

The Medicare GLP-1 Bridge Program, launched July 1, provides both Wegovy and Zepbound at $50 per month to 20 million eligible Americans. Early program data indicate a strong patient preference for injectables, which benefits Lilly's market position. Separately, Novo initiated legal action in July, suing Lilly over alleged false advertising around efficacy comparisons and seeking a preliminary injunction to halt those ads.


Valuation comparison - Market capitalization and valuation multiples highlight a large divergence in how investors price the two firms:

Metric NVO LLY Edge
Market Cap $210B $995B LLY (5x larger)
P/E (LTM) 11.2x 40.3x NVO cheaper
P/E (Fwd) 14.3x 32.6x NVO cheaper
EV/EBITDA 8.0x 29.1x NVO cheaper
Gross Margin 82.4% 83.0% Tie
ROIC 39.5% 45.0% LLY higher
ROE 59.8% 107.6% LLY (leveraged)
Debt/Equity 63.3% 139.0% NVO safer
Dividend Yield 3.9% 0.6% NVO wins
Fair Value Upside +41.6% ($63.94) +5.4% ($1,209) NVO significantly undervalued
Analyst Target Upside 2.7% +16.5% LLY (analysts bullish)
FY+1 Revenue Est. $44.65B $84.94B LLY dominant scale

Bull and bear cases

Novo Nordisk - Value narrative

  • Bull: Novo is trading at a relatively low multiple of 11.2x LTM earnings; a fair value model shows roughly 41.6% upside to $63.94. Oral Wegovy is performing strongly by volume, and a year-to-date price decline of 12.5% may present an entry opportunity.
  • Bear: U.S. injectable Wegovy revenue declined 22% at constant exchange rates amid pricing pressure and a 35% shift to self-pay. The company also faced a pipeline setback when ziltivekimab's ZEUS cardiovascular trial failed, and semaglutide is losing exclusivity in Canada and Brazil.

Eli Lilly - Growth narrative

  • Bull: Lilly's revenue has scaled rapidly, with FY revenue at $65.18B compared with $28.32B five years earlier. Retatrutide's Phase 3 data and a planned filing in Q1 2027 could be transformational. The Medicare program expands access to 20 million patients and Lilly reports a ROIC of 45%.
  • Bear: The shares trade at a premium, reflected in a 40.3x LTM P/E and limited fair value upside of 5.4%. Debt-to-equity is elevated at 139% and rising R&D spend could magnify leverage. Any clinical setback or policy change on pricing could compress Lilly's premium multiple.

Bottom line - The earnings releases reaffirm a clear split in investor choices: Lilly offers scale, current clinical leadership in injectables, and an extensive pipeline that includes retatrutide; Novo presents a lower-priced equity with meaningful modelled upside and a leadership position in oral GLP-1 prescriptions. Investors face a trade-off between a momentum-oriented exposure to Lilly and a contrarian, valuation-driven exposure to Novo.


Historical data referenced is limited to a 10-year window on a Pro+ plan as noted by the companies' reporting materials.

Risks

  • Clinical setbacks and trial failures can materially affect revenue and investor sentiment - evidenced by Novo's ZEUS trial failure and the potential impact on pipelines.
  • Pricing pressure and shifts in payment mix (self-pay vs insured) may reduce reported revenue growth, as seen in U.S. injectable Wegovy revenue which fell 22% at constant exchange rates.
  • Policy changes or shifts in reimbursement programs could alter patient access and addressable market size - the Medicare GLP-1 Bridge Program changes uptake dynamics and early data shows a patient preference that favors injectables.

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