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# The Obesity Evolution: Assessing Revenue Scenarios for Novo & LLY’s Oral Pills in 2026

As we've previously noted, we see 2026 as a pivotal year for the development of the obesity market as it undergoes another structural shift toward accelerating

consumerization with the recent launch of Novo's Wegovy pill which will be followed by Lilly's orforglipron pill, expected in 2Q. Together with the initial unlock of the Medicare population, oral pills are expected to significantly increase the addressable population for obesity medications, expanding the overall market.

Five weeks into the launch of Novo’s oral Wegovy, this dynamic has been playing out with script data showing impressive (and unprecedented) strong early adoption trends driven mostly by new users rather than patients switching from GLP-1 injectables. Investor focus is high on trying to extrapolate these early launch dynamics to assess potential scenarios for both Novo, and for LLY’s orforglipron following its 2Q26 launch, relative to current VA consensus estimates for 2026, for which dispersions are wide. Our recent conversations suggest growing expectations for Novo vs. more tempered expectations developing for LLY.

To assess scenarios on how these launches could play out this year, we interrogated several high-level assumptions comprised of phased growth stages which encapsulate the range of launch trajectories exhibited by injectable Zepbound pen and injectable Wegovy overlaid with different pricing and volume considerations.

For Novo's oral Wegovy pill, our scenario analysis implies a range of c.$0.5bn-2.5bn for FY26 revenue. The low end of the analysis is below our/consensus' estimates. However, given the trajectory of the early launch, this scenario requires an abrupt deceleration, and is looking increasingly too conservative. The majority of our scenarios are substantially above both company-complied consensus (pre-FY25 results) Wegovy pill sales of $800mn and GSe $670mn, and these scenarios imply 1-9% upside risk to our FY26 EBIT forecasts. We will continue to monitor the launch closely. At the start of FY26, Novo shares appeared to be reflecting excitement in the Wegovy pill launch (+21% in late January vs. SXDP +5.5%), but the company's initial 2026 guidance at the FY25 results led to a reversal in enthusiasm (Novo -6% YTD vs. SXDP +6.7%). However, if the Wegovy pill launch continues at the significant initial pace, we expect investor enthusiasm to rebound, which could be a key driver for the Novo shares through 1H'26.

For LLY's orforglipron, current consensus forecasts (for both Bloomberg and Visible

Asad Haider, CFA

+1(212)902-0691 | asad.haider@gs.com

Goldman Sachs & Co. LLC



James Quigley

+44(20)7051-3800 |

james.quigley@gs.com

Goldman Sachs International

Theodora Rowe Beadle +44(20)7552-0177 theodora.beadle@gs.com Goldman Sachs International

Jeff Su

+1(212)357-9930 | jeff.su@gs.com

Goldman Sachs & Co. LLC

Nick Jennings

+1(415)249-7412 | nick.jennings@gs.com

Goldman Sachs & Co. LLC

---

Alpha Data) for FY26 revenues show an extraordinary wide range bracketed by outliers at the low-end at $300mn and the high-end at $4bn vs. a median of ~$1.2bn. Our investor conversations also point to similarly wide dispersions in expectations, underscoring the challenges in forecasting orforglipron across multiple swing factors and a consumerist dynamic that traditional pharmaceutical forecasting models fail to capture. Our theoretical scenarios imply low/mid/high revenues of $1.1bn/$2.0bn/$2.8bn, representing ~470K, 1mn, and 1.7mn patients of therapy by YE26, and we see the mid-case ($2bn) as the most reasonable baseline suggesting upside pressure to our current FY26 forecast of $1.5bn.

Stepping back, we project the oral obesity pill market grows to $35.5bn by 2030 (representing ~35% share of a 2030 AOM TAM we project will be ~$101bn) with orforglipron capturing the majority of the oral market ($19bn in 2030) followed by oral Wegovy ($5.8bn), with the rest split between others. See: The Obesity Evolution: Reflecting Tailwinds To Our AOM Forecasts From Trading Price For Volume, Consumerization Trends.

## Novo Nordisk — Framing the FY26 revenue potential from the Wegovy Pill launch

In light of the latest prescription data (c.38.5k scripts for w/e 6th Feb, per IQVIA data), we frame the Wegovy pill launch potential based on (i) the TRx trajectory at launch of injectable Wegovy and Zepbound, and (ii) our own 3 stage growth scenarios. Our analysis leads to a 2026E revenue range for Wegovy pill of $500mn-$2.5bn, which for most scenarios is substantially ahead of both our estimate (c.$670mn) and pre-4Q25 company consensus (c.$800mn). We lay out our key assumptions below:

We assume 100% of TRx are at the price of the 1.5mg Wegovy pill dose for the first 3 months, decreasing to 60% of TRx by y/e. We assume that c.90% of TRx are 1.5mg+4.0mg by the end of the year, as we expect patients could slowly titrate up to the 9.0mg/25.0mg doses, balancing efficacy/ tolerability, with some patients microdosing the Wegovy pill.

■ We present 5 scenarios, each comprising 3 growth stages, which encapsulate the range of launch trajectories exhibited by injectable Zepbound and injectable Wegovy (Exhibit 1). For each scenario, we assume there are 3 growth rate stages post the early Jan 2026 launch: 1) Jan-March 2026, 2) Apr-Jun 2026, and 3) Jul-Dec 2026. In our “very high” growth scenario, we assume 10%/5%/2% wow TRx growth at each stage, vs 2%/1%/0% wow growth in our “very low” growth scenario. Given the strong first 5 weeks of TRx growth exhibited by the Wegovy pill, the upper end of our range scenario is above that of injectable Zepbound and injectable Wegovy’s launches.

■ We then apply Novo’s pricing schedule to our TRx forecasts ($149/month rising to $199/month for 1.5mg/4.0mg dose, and $299/month for 9.0mg/25.0mg). We assume that 70% of TRx are DTC, and that for the commercial insurance channel prices are 20% higher than the DTC prices disclosed by Novo.

These assumptions imply a range of c.$500mn-$2.5bn in 2026 Wegovy pill revenue (c.DKK 3-18bn revenue) (Exhibit 2), substantially ahead of both our estimate ($670mn) and pre-4Q25 company consensus (c.$800mn). In terms of the number of patients, our scenarios imply c.400k-1.7mn patients taking the Wegovy pill by y/e26 (GSe c.700k). For

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context, earlier this month Novo said they estimate c.240k patients are currently taking the Wegovy pill. Assuming incremental Wegovy pill revenue at a 75% incremental margin, this implies  $ -1\%/ $+9% to our EBIT forecasts for 2026E. If we assume an 60% EBIT margin for incremental Wegovy pill revenue, this implies  $ -0.5\%/ $+7% to our EBIT forecasts for 2026E.

## Exhibit 1: Our 5 scenarios encapture the TRx launch curves of injectable wegovy and zepbound

Implied TRx launch curves for our 5 scenarios, vs actual injectable wegovy, actual injectable zepbound, and if wegovy pill continues to grow at 1.8x injectable zepbound

<div style="text-align: center;"><img src="imgs/img_in_chart_box_352_371_1112_848.jpg" alt="Image" width="62%" /></div>


Source: IQVIA, Company data, Goldman Sachs Global Investment Research

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<div style="text-align: center;">Exhibit 2: Our assumptions imply a range of c.$500mn-$2.5bn in 2026 Wegovy pill revenue Implied 2026 Wegovy pill revenue (USD mn) for each scenario</div>


<div style="text-align: center;"><img src="imgs/img_in_chart_box_343_188_1110_685.jpg" alt="Image" width="62%" /></div>


Source: Goldman Sachs Global Investment Research

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## Eli Lilly — Framing the FY26 revenue potential from orforglipron

As backdrop for our theoretical scenarios for orforglipron adoption and revenues, highlight the following considerations:

No strong consensus. Current consensus forecasts (for both Bloomberg and Visible Alpha Data) for FY26 revenues show an extraordinary wide range bracketed by outliers at the low-end at $300mn and the high-end at $4bn vs. a median of ~$1.2bn. Our investor conversations also point to similarly wide dispersions in expectations, underscoring the challenges in forecasting orforglipron across multiple swing factors and a consumerist dynamic that traditional pharmaceutical forecasting models fail to capture.

■ Recent management framing. On the company's recent 4Q25 earnings call, management provided some helpful high-level qualitative commentary, noting they are very encouraged by the strong early uptake they are seeing from Novo Nordisk's daily oral Wegovy pill as an early validation of GLP-1 market expansion into sidelined consumers, and expressing confidence on the competitiveness of orforglipron's profile which will launch at an entry price similar to oral Wegovy. Management also expects immaterial cannibalization of injectable sales from oral pill launches — we've noted this is an investor concern and we expect ongoing focus on monitoring weekly obesity market scripts.

Theoretical considerations. Alongside the recent oral Wegovy launch from Novo, which has widely exceeded expectations and outpaced historical GLP-1 medication launches, we have complied three theoretical cases for orforglipron launch in 2Q26. In our low/mid/high cases (which account only for US contribution given OUS launches will be mainly in 2027, though we note LLY management expects to launch in some OUS countries such as the UAE in late 2026) we arrive at FY26 orforglipron sales of $1.1bn/2.0bn/$2.8bn. Across these three theoretical scenarios, we see the mid-case ($2bn) as the most reasonable base as it reflects both the readthrough from the strong oral Wegovy launch and other recent obesity launches. This suggests upside pressure to our current FY26 forecast of $1.5bn.

■ Limitations of analysis. We caveat that limitations of this analysis include uncertainty in 1) in approval/launch timing, 2) commercial pricing, 3) volume ramp assumptions which could differ significantly vs. our assumptions in a fast evolving market, 4) volume split across channels, and 5) how patients escalate dosing levels.

With that as backdrop, at a high-level, we make the following assumptions:

1. Orforglipron launches shortly after its  $ \underline{\text{expected April 10th PDUFA}} $ on a similar timeline as Novo's oral Wegovy (which launched some ~10-days after FDA approval). Per LLY's latest filings, the company has  $ \underline{\text{stockpiled 1.5 billion worth of pre-launch inventory.}} $

2. In its initial 5 weeks of launch orforglipron volumes are ~25% below Novo's oral Wegovy pill during that same period — to account for capture rate variability, oral Wegovy's earlier launch, and general conservatism. We apply W/W growth rates from week 5-13, 13-26, 26/39, and 39-52 to reflect observations in the first 5 weeks of the oral Wegovy launch and the compounded growth rates of the first 4 quarters

---

of recent obesity launches.

3. TRx to grow at a compounded rate similar/slightly slower rate vs. the Zepbound pen launch in our mid case.

4. DTC pricing $149-$399 weighted using historical Zepbound vial dose strength ramp, commercial channel price of $500/month, and government channel at $245 per the recent MFN deal with the Trump Administration.

5. TRx to largely split between 70%/30% DTC/commercial, with government channel contribution starting in 2H26 (to represent MSD % of TRx by YE2026).

We lay out our assumptions below:

First 5 weeks: We have used the oral Wegovy launch as a benchmark with adjustment to IQVIA data. In the fourth week of the launch (week ending 1/20/2026), IQVIA recorded 26k in TRx while NVO commented that actual TRx reached ~50k. For the most recent week ending in (2/6/2026), IQVIA reported 38.5k TRx- to account for the under capturing of IQVIA data, we adjusted the 38.5k reported by IQVIA to ~73k by using the prior week's actual/IQVIA ratio. While we recognize this is a broad-stroke estimate we note that Novo management commented that c.240k were up from around c.170k in the week prior — also suggesting c.70k total new prescriptions. We then mapped the first 5 weeks of the launch for oral Wegovy to the orforglipron launch, albeit at a 25% haircut, to account for 1) general variability with IQVIA capture rate, 2) earlier launch of oral Wegovy vs. orforglipron by ~ 1 quarter, where patients awaiting oral options may be on oral Wegovy already; and 3) conservatism.

## Volume Ramp: We then used the following week breakdowns

5-13/13-26/26-39/39-52 to reflect the first four quarters of volume ramp of recent obesity launches, where the 10%/4%/2.5%/2% growth rates in case mid generally represent slightly lower compounded growth rates vs. the Zepbound pen launch, based on the reasoning that Zepbound pen was launching against 1 existing therapy as a superior product, while orforglipron will be launching against 3 products on market where it is still debated whether oral Wegovy or orforglipron is a superior product (given pushes and pulls around efficacy, tolerability, convenience, etc.) On the other hand, we do view the much steeper oral Wegovy ramp vs. injectables as a positive readthrough to the orforglipron launch, in addition to lower price point (high price elasticity of the market vs. traditional pharmaceutical products) and DTC access. Our high and low cases represent incrementally higher/lower compounded growth rates, per Exhibit 3 below.

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<div style="text-align: center;">Exhibit 3: Orforglipron Volume Ramp Assumptions in our Low/Mid/High Scenarios</div>



<table border=1 style='margin: auto; word-wrap: break-word;'><tr><td style='text-align: center; word-wrap: break-word;'>Week 5-13 CAGR</td><td style='text-align: center; word-wrap: break-word;'>Low</td><td style='text-align: center; word-wrap: break-word;'>Mid</td><td style='text-align: center; word-wrap: break-word;'>High</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Orforglipron</td><td style='text-align: center; word-wrap: break-word;'>5.0%</td><td style='text-align: center; word-wrap: break-word;'>10.0%</td><td style='text-align: center; word-wrap: break-word;'>13.0%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Zepbound Pen</td><td style='text-align: center; word-wrap: break-word;'>12.2%</td><td style='text-align: center; word-wrap: break-word;'>12.2%</td><td style='text-align: center; word-wrap: break-word;'>12.2%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Wegovy injectable</td><td style='text-align: center; word-wrap: break-word;'>10.8%</td><td style='text-align: center; word-wrap: break-word;'>10.8%</td><td style='text-align: center; word-wrap: break-word;'>10.8%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Week 13-26 CAGR</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Orforglipron</td><td style='text-align: center; word-wrap: break-word;'>2.0%</td><td style='text-align: center; word-wrap: break-word;'>4.0%</td><td style='text-align: center; word-wrap: break-word;'>5.5%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Zepbound Pen</td><td style='text-align: center; word-wrap: break-word;'>5.0%</td><td style='text-align: center; word-wrap: break-word;'>5.0%</td><td style='text-align: center; word-wrap: break-word;'>5.0%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Wegovy injectable</td><td style='text-align: center; word-wrap: break-word;'>4.5%</td><td style='text-align: center; word-wrap: break-word;'>4.5%</td><td style='text-align: center; word-wrap: break-word;'>4.5%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Week 26-39 CAGR</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Orforglipron</td><td style='text-align: center; word-wrap: break-word;'>1.0%</td><td style='text-align: center; word-wrap: break-word;'>2.5%</td><td style='text-align: center; word-wrap: break-word;'>3.0%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Zepbound Pen</td><td style='text-align: center; word-wrap: break-word;'>2.3%</td><td style='text-align: center; word-wrap: break-word;'>2.3%</td><td style='text-align: center; word-wrap: break-word;'>2.3%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Wegovy injectable</td><td style='text-align: center; word-wrap: break-word;'>1.6%</td><td style='text-align: center; word-wrap: break-word;'>1.6%</td><td style='text-align: center; word-wrap: break-word;'>1.6%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Week 39-52 CAGR</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Orforglipron</td><td style='text-align: center; word-wrap: break-word;'>1.0%</td><td style='text-align: center; word-wrap: break-word;'>2.0%</td><td style='text-align: center; word-wrap: break-word;'>3.0%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Zepbound Pen</td><td style='text-align: center; word-wrap: break-word;'>2.4%</td><td style='text-align: center; word-wrap: break-word;'>2.4%</td><td style='text-align: center; word-wrap: break-word;'>2.4%</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Wegovy injectable</td><td style='text-align: center; word-wrap: break-word;'>-2.5%</td><td style='text-align: center; word-wrap: break-word;'>-2.5%</td><td style='text-align: center; word-wrap: break-word;'>-2.5%</td></tr></table>

Zepbound pen week 5 TRx smoothed for variability in capture rate.

Source: Company data, Goldman Sachs Global Investment Research, IQVIA

Pricing: We make the general assumption that TRx will largely split 70%/30% between DTC and commercial, with more contribution from government channels starting 2H26 (~MSD % of TRx by YE26), noting the actual TRx split could vary and difficult to assess. For the DTC channel, we used the Zepbound vials as a proxy for how patients ramp on doses, and applied the dose level splits for the first 52 weeks to the orforglipron DTC prices ($149-$399). For commercial, we assume $500/month (oral Wegovy list price parity with injectable Wegovy, and additional Y/Y pricing erosion in 2026). For government channels, we assume $245/month per MFN agreement.

Sales: With these assumptions, we arrive at ~$2.0bn sales for FY26 for orforglipron in our mid case, and $2.8bn and $1.1bn in low and high cases with different volume ramp assumptions.

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<div style="text-align: center;">Exhibit 4: Orforglipron FY26 Sales Under Low, Mid, and High Cases</div>



<table border=1 style='margin: auto; word-wrap: break-word;'><tr><td colspan="6">Low Case</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Orfor Revenue Quarterly ($mn)</td><td style='text-align: center; word-wrap: break-word;'>1Q26</td><td style='text-align: center; word-wrap: break-word;'>2Q26</td><td style='text-align: center; word-wrap: break-word;'>3Q26</td><td style='text-align: center; word-wrap: break-word;'>4Q26</td><td style='text-align: center; word-wrap: break-word;'>FY26</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which DTC</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>$106</td><td style='text-align: center; word-wrap: break-word;'>$225</td><td style='text-align: center; word-wrap: break-word;'>$301</td><td style='text-align: center; word-wrap: break-word;'>$632</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which commercial</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>$90</td><td style='text-align: center; word-wrap: break-word;'>$176</td><td style='text-align: center; word-wrap: break-word;'>$207</td><td style='text-align: center; word-wrap: break-word;'>$473</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which Medicare and Medicaid</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>$0</td><td style='text-align: center; word-wrap: break-word;'>$9</td><td style='text-align: center; word-wrap: break-word;'>$18</td><td style='text-align: center; word-wrap: break-word;'>$28</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Total</td><td style='text-align: center; word-wrap: break-word;'>$196</td><td style='text-align: center; word-wrap: break-word;'>$411</td><td style='text-align: center; word-wrap: break-word;'>$526</td><td style='text-align: center; word-wrap: break-word;'>$1,133</td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Orfor Volume (TRx) Quarterly</td><td style='text-align: center; word-wrap: break-word;'>1Q26</td><td style='text-align: center; word-wrap: break-word;'>2Q26</td><td style='text-align: center; word-wrap: break-word;'>3Q26</td><td style='text-align: center; word-wrap: break-word;'>4Q26</td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which DTC</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>419,619</td><td style='text-align: center; word-wrap: break-word;'>803,967</td><td style='text-align: center; word-wrap: break-word;'>989,904</td><td style='text-align: center; word-wrap: break-word;'>2,213,490</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which commercial</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>180,120</td><td style='text-align: center; word-wrap: break-word;'>351,913</td><td style='text-align: center; word-wrap: break-word;'>413,904</td><td style='text-align: center; word-wrap: break-word;'>945,938</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which Medicare and Medicaid</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>662</td><td style='text-align: center; word-wrap: break-word;'>38,479</td><td style='text-align: center; word-wrap: break-word;'>74,422</td><td style='text-align: center; word-wrap: break-word;'>113,563</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Total</td><td style='text-align: center; word-wrap: break-word;'>600,402</td><td style='text-align: center; word-wrap: break-word;'>1,194,359</td><td style='text-align: center; word-wrap: break-word;'>1,478,230</td><td style='text-align: center; word-wrap: break-word;'>3,272,991</td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td colspan="6">Mid Case</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Orfor Revenue Quarterly ($mn)</td><td style='text-align: center; word-wrap: break-word;'>1Q26</td><td style='text-align: center; word-wrap: break-word;'>2Q26</td><td style='text-align: center; word-wrap: break-word;'>3Q26</td><td style='text-align: center; word-wrap: break-word;'>4Q26</td><td style='text-align: center; word-wrap: break-word;'>FY26</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which DTC</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>$122</td><td style='text-align: center; word-wrap: break-word;'>$368</td><td style='text-align: center; word-wrap: break-word;'>$615</td><td style='text-align: center; word-wrap: break-word;'>$1,106</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which commercial</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>$104</td><td style='text-align: center; word-wrap: break-word;'>$287</td><td style='text-align: center; word-wrap: break-word;'>$423</td><td style='text-align: center; word-wrap: break-word;'>$813</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which government</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>$0</td><td style='text-align: center; word-wrap: break-word;'>$16</td><td style='text-align: center; word-wrap: break-word;'>$37</td><td style='text-align: center; word-wrap: break-word;'>$53</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Total</td><td style='text-align: center; word-wrap: break-word;'>$226</td><td style='text-align: center; word-wrap: break-word;'>$671</td><td style='text-align: center; word-wrap: break-word;'>$1,076</td><td style='text-align: center; word-wrap: break-word;'>$1,972</td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Orfor Volume (TRx) Quarterly</td><td style='text-align: center; word-wrap: break-word;'>1Q26</td><td style='text-align: center; word-wrap: break-word;'>2Q26</td><td style='text-align: center; word-wrap: break-word;'>3Q26</td><td style='text-align: center; word-wrap: break-word;'>4Q26</td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which DTC</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>482,947</td><td style='text-align: center; word-wrap: break-word;'>1,311,136</td><td style='text-align: center; word-wrap: break-word;'>2,022,237</td><td style='text-align: center; word-wrap: break-word;'>3,816,319</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which commercial</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>207,370</td><td style='text-align: center; word-wrap: break-word;'>573,218</td><td style='text-align: center; word-wrap: break-word;'>845,693</td><td style='text-align: center; word-wrap: break-word;'>1,626,282</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which government</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>917</td><td style='text-align: center; word-wrap: break-word;'>64,178</td><td style='text-align: center; word-wrap: break-word;'>152,403</td><td style='text-align: center; word-wrap: break-word;'>217,498</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Total</td><td style='text-align: center; word-wrap: break-word;'>691,234</td><td style='text-align: center; word-wrap: break-word;'>1,948,532</td><td style='text-align: center; word-wrap: break-word;'>3,020,333</td><td style='text-align: center; word-wrap: break-word;'>5,660,099</td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td colspan="6">High Case</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Orfor Revenue Quarterly ($mn)</td><td style='text-align: center; word-wrap: break-word;'>1Q26</td><td style='text-align: center; word-wrap: break-word;'>2Q26</td><td style='text-align: center; word-wrap: break-word;'>3Q26</td><td style='text-align: center; word-wrap: break-word;'>4Q26</td><td style='text-align: center; word-wrap: break-word;'>FY26</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which DTC</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>$133</td><td style='text-align: center; word-wrap: break-word;'>$501</td><td style='text-align: center; word-wrap: break-word;'>$948</td><td style='text-align: center; word-wrap: break-word;'>$1,581</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which commercial</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>$113</td><td style='text-align: center; word-wrap: break-word;'>$389</td><td style='text-align: center; word-wrap: break-word;'>$651</td><td style='text-align: center; word-wrap: break-word;'>$1,153</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which Medicare and Medicaid</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>$0</td><td style='text-align: center; word-wrap: break-word;'>$22</td><td style='text-align: center; word-wrap: break-word;'>$58</td><td style='text-align: center; word-wrap: break-word;'>$79</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Total</td><td style='text-align: center; word-wrap: break-word;'>$247</td><td style='text-align: center; word-wrap: break-word;'>$911</td><td style='text-align: center; word-wrap: break-word;'>$1,656</td><td style='text-align: center; word-wrap: break-word;'>$2,814</td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Orfor Volume (TRx) Quarterly</td><td style='text-align: center; word-wrap: break-word;'>1Q26</td><td style='text-align: center; word-wrap: break-word;'>2Q26</td><td style='text-align: center; word-wrap: break-word;'>3Q26</td><td style='text-align: center; word-wrap: break-word;'>4Q26</td><td style='text-align: center; word-wrap: break-word;'></td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which DTC</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>526,881</td><td style='text-align: center; word-wrap: break-word;'>1,779,175</td><td style='text-align: center; word-wrap: break-word;'>3,113,719</td><td style='text-align: center; word-wrap: break-word;'>5,419,774</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which commercial</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>226,281</td><td style='text-align: center; word-wrap: break-word;'>777,109</td><td style='text-align: center; word-wrap: break-word;'>1,302,222</td><td style='text-align: center; word-wrap: break-word;'>2,305,612</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>of which Medicare and Medicaid</td><td style='text-align: center; word-wrap: break-word;'></td><td style='text-align: center; word-wrap: break-word;'>1,107</td><td style='text-align: center; word-wrap: break-word;'>88,475</td><td style='text-align: center; word-wrap: break-word;'>234,853</td><td style='text-align: center; word-wrap: break-word;'>324,435</td></tr><tr><td style='text-align: center; word-wrap: break-word;'>Total</td><td style='text-align: center; word-wrap: break-word;'>754,269</td><td style='text-align: center; word-wrap: break-word;'>2,644,759</td><td style='text-align: center; word-wrap: break-word;'>4,650,794</td><td style='text-align: center; word-wrap: break-word;'>8,049,822</td><td style='text-align: center; word-wrap: break-word;'></td></tr></table>

Source: Goldman Sachs Global Investment Research

<div style="text-align: center;">Exhibit 5: Orforglipron TRx Scenarios for FY26 vs. Recent Obesity Launches</div>


<div style="text-align: center;">TRx Orfor Scenarios vs. Recent Obesity Launches</div>


<div style="text-align: center;"><img src="imgs/img_in_chart_box_338_959_1096_1360.jpg" alt="Image" width="61%" /></div>


Source: Goldman Sachs Global Investment Research

---

<div style="text-align: center;">Exhibit 6: Orfor FY26 Projections Under Our Theoretical Low, Mid, and High Cases</div>


<div style="text-align: center;"><img src="imgs/img_in_chart_box_247_185_998_646.jpg" alt="Image" width="61%" /></div>


Source: Goldman Sachs Global Investment Research, Visible Alpha Consensus Data, Bloomberg

## Valuation and Risks

## Novo Nordisk (Buy)

We are Buy rated on Novo Nordisk. We derive our price target from a 50:50 blend of DCF and EV/EBITDA approaches. Our bottom-up DCF analysis suggests a valuation of DKK 430/share. We use a WACC of 7.1% and a TGR of 0% (unchanged). On a multiples basis, we believe Novo Nordisk should trade on 18.0x P/E on our 2027 EPS estimate (unchanged), implying DKK 380/share. As a result, our 12-month price target is DKK 400/share. Our ADR PT is set with reference to the Danish line, translated at the current FX rate, leading to an ADR PT of $63.0.

## Key downside risks to our view and price target include:

(1) clinical risks if CagriSema and/or amycretin development were to be unsuccessful; (2) slower-than-expected scale-up in manufacturing for Wegovy/Ozempic; (3) stronger-than-anticipated competitor obesity data, particularly oral small molecule GLP-1 based assets; and (4) deeper and sustained price pressure.

## Eli Lilly (Buy)

We are Buy rated on Eli Lilly. We apply a 30.0x (unchanged) P/E multiple on our Q5-Q8 EPS estimates to arrive at our 12-month price target of $1260.

Downside risks: A greater-than-expected annual pricing decline in the obesity market. Lower-than-expected market share due to either external competition or internal lack of execution on its current and pipeline assets could present downside to our estimates.

---

Worse-than-expected data pipeline assets could result in significant downside to our medium-to-long-term estimates and lead to multiple compression of the stock.

最新摘要 (Detailed Summary)

生成于 2026-02-19 15:13

核心概览

高盛认为,2026年是肥胖症药物市场的结构性转折点。核心驱动有三点:口服化加速、消费化扩圈、以及Medicare人群开始解锁。
诺和诺德口服Wegovy上市5周后,处方数据已显示“历史上少见”的早期放量,且增量主要来自新患者,而非从GLP-1注射剂转用。市场因此高度关注这条早期曲线,试图外推诺和诺德与礼来在2026年的收入空间。高盛与投资者交流也显示:市场对诺和诺德预期在抬升,对礼来预期相对更谨慎。

术语说明:文中“处方量”对应TRx(总处方量);“直面消费者渠道”对应DTC。

详细总结

一、2026年的共同逻辑:口服药把市场从“替代”推向“扩容”

  • 口服剂型叠加Medicare初步放开,预计将显著扩大抗肥胖药物可及人群,带动总市场扩张。
  • 口服Wegovy上市前5周的强势表现,验证了“新增需求释放”的可能性,而不只是针剂内部替代。

二、诺和诺德:口服Wegovy的2026年收入弹性显著

高盛基于历史注射剂上市曲线(Wegovy、Zepbound)叠加三阶段增长假设,构建5种情景,得到口服Wegovy 2026年收入区间约5亿—25亿美元
其中,多数情景明显高于:
- 高盛自身预测:6.7亿美元
- 公司汇总一致预期(pre-4Q25/pre-FY25结果前):8亿美元

关键点包括:
- 若落在低端情景,需要处方增速“突然明显降档”,在当前早期轨迹下显得偏保守。
- IQVIA数据显示,截至2月6日当周处方量约3.85万
- 情景对应年末患者约40万—170万(高盛原估约70万);公司口径称当前约24万人在用。
- 若按增量利润率75%,对应2026年息税前利润(EBIT)影响约-1%到+9%(若按60%利润率则约-0.5%到+7%)。
- 股价层面,诺和诺德曾在1月下旬因口服药预期明显走强(约+21%,同期SXDP约+5.5%),但随后受公司2026年初始指引影响回吐(年初至今约-6%,同期SXDP约+6.7%)。高盛认为,若处方高增持续,1H26情绪有望修复。

三、礼来:orforglipron分歧大,但中性情景有上行压力

高盛指出,礼来orforglipron的2026年一致预期离散度极高(约3亿—40亿美元,中位数约12亿美元),反映该市场受消费化与多变量影响,传统药企预测框架难以完全覆盖。

高盛给出的理论情景(以美国市场为主)为:
- 低情景:11亿美元
- 中情景:20亿美元
- 高情景:28亿美元

对应年末治疗患者约47万 / 100万 / 170万。高盛认为20亿美元是更合理基线,高于其当前15亿美元预测,存在上行压力。

主要建模设定:
- 假设在预计4月10日PDUFA后不久上市,节奏参考口服Wegovy获批后约10天上市;礼来已储备约15亿美元上市前库存。
- 首5周处方量按口服Wegovy同阶段做约25%折减,以反映先发差异与保守假设。
- 增长分四段(5-13周、13-26周、26-39周、39-52周);中情景增速设为约10%/4%/2.5%/2%。
- 定价与渠道:DTC约149—399美元/月,商业渠道约500美元/月,政府渠道约245美元/月;处方量初期以DTC/商业约70/30为主,政府渠道在2H26开始贡献。
- 高盛同时提示不确定性:审批与上市时点、商业定价、放量斜率、渠道结构、剂量升级路径。

四、长期市场判断与估值立场

  • 高盛预计2030年口服减重药市场约355亿美元,约占2030年抗肥胖药物总可服务市场(约1010亿美元)的35%
  • 其中,orforglipron预计占口服市场最大份额(约190亿美元),口服Wegovy约58亿美元,其余由其他产品分配。

评级与目标价:
- 诺和诺德:买入,12个月目标价DKK 400(ADR约63美元)。
- 礼来:买入,12个月目标价1260美元

主要下行风险:
- 诺和诺德:关键管线临床不及预期、产能爬坡慢、竞品数据更强、价格压力持续。
- 礼来:降价幅度超预期、份额不及预期、管线数据偏弱引发中长期盈利与估值下修。