Eli Lilly's 60% obesity drug market share explains its stock surge over Novo Nordisk

Novo Nordisk is pushing to extract greater value from semaglutide by expanding its use beyond traditional diabetes, obesity and cardiovascular indications, even as it faces intense competition from Eli Lilly across cardiometabolic care. Semaglutide-based GLP-1 products, including Ozempic and Rybelsus for type II diabetes and Wegovy for obesity, accounted for roughly 75.5% of Novo's adjusted first-half 2026 sales, leaving the company highly exposed to changes in competition, pricing and market share. The clearest example of the expansion came with Wegovy's 2025 U.S. approval for noncirrhotic metabolic dysfunction-associated steatohepatitis in adults with moderate-to-advanced liver fibrosis, and in March 2026 the European Commission granted conditional authorization to Kayshild, or semaglutide, for adults with noncirrhotic MASH and F2-F3 liver fibrosis. Novo is also building evidence in knee osteoarthritis, where the STEP 9 study showed significant improvements in pain and physical function among adults with obesity, and in post-hoc analyses of obstructive sleep apnea and asthma-related outcomes, though these remain opportunities rather than established indications. The company's Alzheimer's disease program for semaglutide was discontinued after the phase III EVOKE and EVOKE+ studies failed to meet their primary endpoints. Eli Lilly is pursuing a similarly broad strategy, with Mounjaro approved in the United States to reduce major cardiovascular events in adults with T2D at high cardiovascular risk, Zepbound approved for adults with obesity and moderate-to-severe OSA, the oral GLP-1 pill Foundayo being studied across multiple conditions, and retatrutide in late-stage studies. In MASH, Madrigal Pharmaceuticals' Rezdiffra generated $675.6 million in first-half 2026 sales, up 93% year over year, while Altimmune's pemvidutide is in the phase III PERFORMA study with a potential 52-week readout not expected until 2029. Year to date, Novo shares have lost 26.2% against the industry's 8.9% growth, and the stock trades at 10.92 forward earnings versus 17.49 for the industry, while 2026 earnings estimates have risen from $3.40 to $3.53 per share over the past 60 days.

AstraZeneca has opened a new US$1b global research and development center in Kendall Square, Massachusetts, consolidating its US work in oncology, cell therapy, chronic and rare diseases, and obesity into a single expanded hub. The site uses robotics and AI-enabled automation to support the company's research programs and broader drug development efforts. AstraZeneca is a GB-based biopharmaceutical group with a £185.5 billion market cap that spends heavily on discovering and developing prescription medicines. The company said the center tightens the link between early science and late-stage assets, which could affect how quickly it refines drug candidates and retires weaker programs. Investors will be watching for Phase II or Phase III readouts in obesity, COPD and key oncology programs over 2027 to 2029 as markers of whether the build-out is translating into a more resilient portfolio mix.

Novo Nordisk is rated Zacks Rank #3 (Hold), with the Zacks Consensus Estimate for the current quarter rising 6.9% over the last 30 days to $0.80 per share, a year-over-year change of -21.6%. For the current fiscal year, the consensus earnings estimate of $3.53 points to a change of -10.9% from the prior year and has moved +2.4% over the last 30 days, while the next fiscal year's estimate of $3.41 indicates a -3.5% change and has slipped -0.3% over the past month. Consensus sales estimates stand at $11.41 billion for the current quarter, $46.1 billion for the current fiscal year and $47.16 billion for the next fiscal year, indicating changes of -2.8%, -1.5% and +2.3%, respectively. In the last reported quarter, Novo Nordisk posted revenues of $12.21 billion, up 4.5% year over year and an 8.34% surprise over the Zacks Consensus Estimate of $11.27 billion, with EPS of $0.96 versus $0.97 a year ago and a +17.07% EPS surprise. The stock is graded A on the Zacks Value Style Score, indicating it trades at a discount to its peers, though its Zacks Rank #3 suggests it may perform in line with the broader market near term.