Overview
Novo Nordisk released late-stage trial results for its next-generation obesity medicine, CagriSema, that fell short of expectations and underscored Eli Lilly’s growing commercial lead in the weight-loss drug category. The data showed an average 23% reduction in body weight for participants after 84 weeks on CagriSema, compared with 25.5% for Lilly’s tirzepatide in the same trial. The market reaction was immediate: Novo shares plunged 16% while Eli Lilly’s stock rose 5%.
Summary
The CagriSema outcome aligns with prior efficacy signals from Novo but contrasted unfavourably with Lilly’s performance in the trial, and even exceeded some earlier comparisons where Lilly’s results had been lower over shorter durations. Investors and analysts seized on the new data as further evidence that Lilly is consolidating its advantage in obesity treatments, a market Novo helped create with Wegovy but where competition has intensified.
What the numbers show
In the trial disclosed by Novo, CagriSema delivered a 23% average reduction in body weight at 84 weeks. The comparator, tirzepatide - marketed by Lilly as Zepbound and as Mounjaro in Europe - produced a 25.5% reduction in body weight in the same study. Those results track with earlier CagriSema findings but are higher than Lilly’s results in some prior Zepbound trials that covered shorter timeframes.
Investor and analyst reaction
Market participants were vocal. BMO Capital’s Evan Seigerman said bluntly, "They literally ran a trial that said that Lilly’s product is better," and questioned whether repeated disappointments would convince investors to remain confident in Novo’s program, adding, "They’ve tried twice and they’ve now disappointed twice. So why should we believe that this is going to be any different?"
One Novo shareholder who requested anonymity described the company’s management explanation as a "lame excuse," while Deutsche Bank analysts concluded the diabetes and obesity market was "likely to coalesce around Lilly’s portfolio," citing Lilly’s deep product range. JP Morgan analysts commented that it will be difficult for Novo to dislodge Lilly’s market share, with Zepbound already well established.
HSBC senior analyst Rajesh Kumar wrote that the trial "seems to further raise the question of the value proposition of CagriSema in the obesity market landscape." Barclays warned the results make it harder for Novo to persuade patients and physicians to choose CagriSema over what it described as "more effective, better tolerated Zepbound," leaving "Novo little to compete on apart from price."
Management response
Novo’s leadership sought to contextualize the outcome. CEO Mike Doustdar characterised Zepbound’s showing as an "abnormality," and said that once approved, CagriSema would carry superior label data. Chief Scientific Officer Martin Holst Lange urged patience to fully assess CagriSema’s potential. During an investor call, Deutsche Bank analyst Emmanuel Papadakis asked whether CagriSema was now "obsolete" as a competitive upgrade to Wegovy.
Market position and broader context
The result compounds prior setbacks for Novo in its obesity program and arrives after a period of strategic and operational challenges for the company. Novo pioneered the modern GLP-1-based obesity market with the Wegovy injection, which helped make the company the most valuable listed European firm in 2024. Since then, the two firms have diverged: Lilly has vaulted to a trillion-dollar valuation while Novo has navigated profit warnings, management turnover and softer sales. Novo also lost a bidding contest for the obesity biotech Metsera last year.
Lilly already demonstrated a clinical edge with Zepbound versus Wegovy, and it has additional momentum in the oral obesity therapy space: Lilly expects U.S. approval for its rival pill in April. Novo did capture an early win by getting its weight-loss pill to market in the United States ahead of Lilly, but the CagriSema data complicate the company’s path to regain a larger share of the obesity market.
Implications for stakeholders
For investors, the trial highlights the competitive dynamics shaping valuations in the obesity and diabetes sector. For physicians and patients, the data raise comparative efficacy and tolerability questions between products. For payers and health systems, the evolving clinical profiles will factor into formulary and coverage decisions, particularly if competition shifts primarily to price.
Key points
- Novo’s CagriSema showed a 23% average body-weight reduction at 84 weeks versus 25.5% for Lilly’s tirzepatide in the trial, prompting a 16% drop in Novo shares and a 5% gain for Lilly.
- Analysts from multiple banks suggested the market may consolidate around Lilly’s portfolio, citing Zepbound’s clinical strength and product breadth.
- The result deepens challenges for Novo as it seeks to regain market share amid prior profit warnings, leadership changes and the loss of a bidding contest for Metsera.
Risks and uncertainties
- Future trial outcomes and regulatory reviews - The article notes additional trials for CagriSema remain, and the path to convincing investors and clinicians depends on forthcoming data.
- Market adoption and prescribing decisions - Analysts warned that persuading patients and physicians to choose CagriSema over Zepbound could be difficult, potentially limiting uptake.
- Competitive pressure on pricing and market share - Barclays and others suggested Novo may be left competing primarily on price if efficacy and tolerability favour Lilly, creating margin and revenue risks.