Just three years after Eli Lilly received Food and Drug Administration (FDA) approval for Zepbound, the company’s weight-loss drug based on the GLP-1 receptor agonist, tirzepatide, it has received approval for a different GLP-1 analog, orforglipron, to be sold in pill form as “Foundayo.”

GLP-1 drugs in pill form have long been forecast to generate billions of dollars in revenue for pharmaceutical manufacturers. CNBC’s London-based reporter, Elsa Ohlen, writes that Foundayo’s approval is “the start of the next phase of the weight-loss drug era.”

Vox‘s health journalist, Dylan Scott, explains why the pill version of GLP-1 drugs is potentially such a big deal:

[T]he gap between the share of Americans who have tried a GLP-1 drug (about 12 percent as of last year) and the share who are obese (about 37 percent) suggests there is a sizable percentage of people who could benefit from these drugs but have not been taking them.

Eli Lilly is banking on hopes that a pill version of the drug that does not require injection could double the market for GLP-1 drugs. Lilly is so confident that it has reformulated the pill rather than leverage the Zepbound brand name, and thereby extended the patent life for Foundayo.

Orforglipron is not a peptide, like Zepbound. Rather, it is a small-molecule drug that is relatively inexpensive to manufacture. “We can basically make as much as we need,” Eli Lilly CEO Dave Ricks bragged to Vox. Compared with an injectable, the pill form is much cheaper to distribute, store, and use. And Foundayo has fewer problem interactions with other drugs.

Hold on just a minute, says drug manufacturer Novo Nordisk. They have also received approval for a pill form of their blockbuster weight loss drug, Wegovy. The pill version carries the same brand name and a similar formulation as the injectable version. But it performs much better than Eli Lilly’s pill, says CNBC:

The Wegovy pill showed more pronounced weight loss and less cumbersome side effects than Eli Lilly’s rival pill.

Novo Nordisk says an “indirect study” “suggests” that 84% of patients prefer a semaglutide pill to a orforglipron pill. And studies have shown that oral Wegovy results in an average of 16.6% weight loss, while Foundayo showed 12.4% on average among patients who stayed on the treatment.

Not so fast, shot back Lilly CEO Dave Ricks in a CNBC back-and-forth. “Foundayo can be taken without food restrictions, while the Wegovy pill needs to be taken first thing in the morning on an empty stomach with only a small amount of water, and patients must wait at least 30 minutes before eating.”

An estimated 600,000 Americans are currently taking the Wegovy pill, according to CNBC, noting, “Analysts have described it as one of the best launches of a new medicine ever.” In a survey of 200 patients currently taking injectable GLP-1 drugs, the lack of dosing restrictions for the Foundayo pill led them to theoretically prefer it to the Wegovy pill.

With GLP-1 drugs now showing promise at preventing and treating substance use disorders, both Eli Lilly and Novo Nordisk can look forward to billions of dollars in revenues for years to come. And consumers can look forward to a competitive marketplace with new pricing restrictions that make GLP-1 drugs affordable for millions more Americans.

Written by Steve O’Keefe. First published April 8, 2026.

Sources:

“Novo Nordisk says Wegovy pill outperforms Lilly’s oral GLP-1 in cross-trial comparison,” CNBC, April 2, 2026.

“Why the new GLP-1 pill is such a big deal,” Vox, April 1, 2026.

“FDA Approves Orforglipron, First GLP-1 Pill Without Time, Food, or Water Restrictions,” Pharmacy Times, April 1, 2026.

Image courtesy of The Vesey, used under Creative Commons license.