Key Points
- The weight loss drug market is experiencing a significant shift from injectable GLP-1 drugs to oral medications, driven by patient preference and practical advantages.
- While injectables like Eli Lilly’s tirzepatide generated massive revenue ($36.5 billion USD in 2025), they faced challenges related to injections, cold chain storage, and accessibility.
- Oral semaglutide (from Novo Nordisk) launched in early 2026 with strong uptake (50,000 weekly prescriptions in three weeks), but Eli Lilly’s orforglipron (a small molecule drug) is expected to launch in mid-2026, potentially offering better efficacy and simpler, cheaper manufacturing.
- Chinese pharmaceutical companies like Jiangsu Hengrui Pharmaceuticals (恒瑞医药), Huadong Medicine (华东医药), and Innovent Biologics (信达生物) are actively developing and advancing competitive oral GLP-1 drugs, with some already in Phase 3 trials.
- The upcoming patent cliff for semaglutide in 2026, particularly in markets like China, is expected to usher in a “universal access” phase with lower prices and broader adoption, creating significant opportunities for generic and oral formulation manufacturers.
- Novo Nordisk: First mover with oral semaglutide (peptide-based); launched Jan 2026 with high initial uptake.
- Eli Lilly: Orforglipron (small molecule) expected mid-2026; Phase 3 data shows superior efficacy and potential cost advantages.
- AstraZeneca: Developing elecoglipron (licensed from Eccogene); currently in Phase 3.
- Jiangsu Hengrui: Advancing oral dual receptor agonists; Phase 2 positive data released Feb 2026.
- Huadong Medicine: HDM1002 small molecule in Phase 3 enrollment for weight management.
The weight loss drug industry just entered a new era.
For the past five years, injectable GLP-1 drugs have dominated the pharmaceutical world.
But as of early 2026, that’s changing fast.
The shift from needle-based treatments to oral pills is reshaping everything—from manufacturing to market access to who wins the biggest share of a multi-billion dollar opportunity.
How We Got Here: The Five-Year Explosion
Let’s rewind to 2021.
That’s when Novo Nordisk (Nuowo Nuode 诺和诺德) got FDA approval for semaglutide injection for chronic weight management.
Nobody expected what happened next.
By 2025, the weight loss drug market had become the hottest sector in pharma.
Eli Lilly’s (Li Lai 礼来) tirzepatide captured the title of world’s top-selling drug with annual sales hitting $36.5 billion USD (¥262.8 billion RMB).
Let that sink in.
One drug.
Over $36 billion in a single year.
For context, that’s more revenue than most Fortune 500 companies generate.
The Injection Problem Nobody Talked About (Until Now)
Here’s the thing though—these blockbuster drugs had a weakness nobody wanted to admit out loud.
They came in once-weekly injections.
Sure, once a week sounds convenient.
But “once a week” still means a needle.
And needles scare people.
Beyond needle anxiety, the practical challenges were real:
- Injectable medications require strict cold-chain transportation and storage
- This limits accessibility in regions without reliable refrigeration infrastructure
- Compliance drops when patients need to manage injection supplies
- Patients with needle phobias avoid treatment entirely
These weren’t minor inconveniences.
These were barriers keeping millions of potential patients from accessing treatment.
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The Breakthrough: Oral Semaglutide Changes Everything
On December 22, 2025, the FDA approved something everyone was waiting for.
The first oral GLP-1 weight loss drug.
Novo Nordisk’s oral semaglutide launched on January 5, 2026.
The response was immediate.
By January 23—just three weeks in—weekly prescriptions hit approximately 50,000.
That’s not a slow rollout.
That’s momentum.
Patients wanted this.
They wanted to skip the needle.
They wanted to swallow a pill instead.
But Novo Nordisk Shouldn’t Get Comfortable
Here’s where it gets interesting.
Novo Nordisk broke through the oral barrier first.
But they won’t own that space for long.
Eli Lilly is coming with something different.
And it might be better.
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Small Molecules vs. Peptides: The Technical Battle
To understand what’s happening next, you need to know the difference between two approaches.
Novo Nordisk’s Strategy: Peptide-Based
Novo Nordisk’s oral semaglutide is a peptide-based drug.
It mimics how the injectable version works, just in pill form.
This approach had a proven track record in the market.
The downside?
Peptide drugs are complex to manufacture and expensive to produce at scale.
Eli Lilly’s Approach: Small Molecule
Eli Lilly is taking a different path.
Their oral GLP-1 drug, orforglipron, is a small molecule.
Think of it this way:
Peptides are like massive, complex structures that are hard to manufacture.
Small molecules are simpler, more elegant, and easier to mass-produce.
In September 2025, Eli Lilly released results from their Phase 3 ACHIEVE-3 study.
The findings were compelling.
In a 52-week head-to-head comparison:
- Orforglipron outperformed oral semaglutide in blood sugar control (A1C reduction)
- Orforglipron showed superior weight reduction results
- All orforglipron dose groups met primary and key secondary endpoints
This matters because it shows small molecule drugs aren’t just cheaper to make—they might actually work better.
Research from Shanghai Securities (Shanghai Zhengquan 上海证券) confirms this advantage:
Small molecule products have simpler manufacturing processes and better cost control compared to oral peptide formulations.
If small molecule GLP-1 drugs maintain their safety and efficacy profile long-term, they could fundamentally disrupt the market landscape.
Cheaper manufacturing.
Better efficacy.
Lower prices for patients.
That’s a recipe for market dominance.
Eli Lilly’s orforglipron already has an FDA New Drug Application submitted and is expected to launch in the first half of 2026.
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The Global Race: Who Else Is Competing?
This isn’t just a Novo Nordisk vs. Eli Lilly fight.
Major pharmaceutical companies worldwide are all-in on oral GLP-1 drugs.
AstraZeneca’s Move
AstraZeneca (Asili Kang 阿斯利康) acquired global rights to elecoglipron from Chinese biotech firm Eccogene (Chengyi Shengwu 诚益生物).
Elecoglipron recently met primary endpoints in two Phase 2b clinical trials for both obesity and Type 2 diabetes.
The drug is now advancing to Phase 3 development.
This is a smart acquisition by AstraZeneca—they’re betting on a Chinese biotech innovation rather than developing from scratch.
The Chinese Companies Making Major Moves
Here’s what surprised many global investors:
Chinese pharmaceutical companies aren’t waiting for the West to lead anymore.
They’re actively developing competitive oral GLP-1 drugs right now.
Jiangsu Hengrui Pharmaceuticals (Hengrui Yiyao 恒瑞医药)
Pipeline Drug: Repotrectinib (Ruipubo Tai 瑞普泊肽), a GLP-1/GIP dual receptor agonist with an oral tablet form.
Latest Update: On February 10, 2026, Hengrui and partner Kailera announced positive Phase 2 data from a trial of 166 obese adults in China.
The dual receptor approach is particularly interesting—it targets two pathways simultaneously, potentially offering better weight loss results than single-target drugs.
Huadong Medicine (Huadong Yiyao 华东医药)
Pipeline Drug: HDM1002, an oral small molecule GLP-1 receptor agonist.
Status: Completed enrollment for its Phase 3 weight management study in China.
Phase 3 completion is a major milestone—it means data could be submitted for regulatory approval soon.
InnoCare Pharma (Derui Zhiyao 德睿智药)
Pipeline Drug: MDR-001, a small molecule candidate.
Status: Began Phase 3 trials in January 2026.
Innovent Biologics (Xinda Shengwu 信达生物)
Pipeline Drug: IBI3023, an oral small molecule GLP-1 agonist.
Status: Currently running Phase 1 trials simultaneously in both China and the U.S.
This dual-market approach shows confidence in the drug’s potential for global expansion.
Hansoh Pharmaceutical (Hansen Zhiyao 翰森制药)
Strategy: In 2024, licensed their oral small molecule GLP-1 receptor agonist to Merck (Moshadong 默沙东).
Status: Currently in clinical development stages.
This partnership model shows how Chinese biotech is becoming the innovation partner for global pharma giants.
What This Means for the Market
The shift from injections to oral medications is bigger than just convenience.
It’s a fundamental market transformation.
Injectables Aren’t Going Away
Don’t expect injectable GLP-1 drugs to disappear.
For now, injectables will coexist with oral options.
But the market expectations are shifting.
Patients and doctors now want more:
- Even better weight loss results
- Solutions for muscle loss preservation (a known side effect)
- Longer-lasting effects with less frequent dosing
- Fewer side effects
The bar has been raised.
The Patent Cliff Is Coming
Here’s the inflection point that changes everything:
The core patent for semaglutide is set to expire in several markets, including China.
When that happens—likely in 2026—generic manufacturers will flood the market.
The era of the “thousand-yuan injection” (approximately ¥1,000 RMB / $140 USD) is about to end.
What comes next is the “universal access” phase.
This means:
- Dramatically lower prices as competition increases
- GLP-1 therapies penetrating beyond top-tier cities
- Access expanding into second, third, and lower-tier cities
- Broader mass market adoption across income levels
- Generic oral formulations becoming the standard
For patients, this is good news.
For Novo Nordisk and Eli Lilly, this changes the competitive dynamics entirely.
They’ll need to either compete on volume at lower prices or differentiate with superior formulations.
For Chinese manufacturers, this is the opening they’ve been waiting for.
Why This Matters to Investors and Founders
The weight loss drug market transformation represents one of the biggest pharmaceutical opportunities of the decade.
The timeline is compressing.
What took five years to build with injectables will likely happen in two years with oral drugs.
Multiple companies will have approved oral GLP-1 drugs by late 2026 or early 2027.
The winners will be:
- Companies with superior small molecule formulations
- Manufacturers with cost-competitive production capabilities
- Players positioned in high-growth emerging markets like China
- Innovators working on next-generation solutions (dual receptors, muscle preservation, etc.)
The losers will be:
- Companies dependent on injectable market dominance
- Manufacturers unable to compete on cost
- Players slow to transition to oral formulations
The weight loss drug market is moving from a duopoly to an oligopoly to a competitive landscape.
The shift to oral medications is accelerating that timeline.
Welcome to the next chapter of pharmaceutical disruption.
