# 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 --- 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
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Source: IQVIA, Company data, Goldman Sachs Global Investment Research ---
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
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Source: Goldman Sachs Global Investment Research --- ## 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. ---
Exhibit 3: Orforglipron Volume Ramp Assumptions in our Low/Mid/High Scenarios
Week 5-13 CAGRLowMidHigh
Orforglipron5.0%10.0%13.0%
Zepbound Pen12.2%12.2%12.2%
Wegovy injectable10.8%10.8%10.8%
Week 13-26 CAGR
Orforglipron2.0%4.0%5.5%
Zepbound Pen5.0%5.0%5.0%
Wegovy injectable4.5%4.5%4.5%
Week 26-39 CAGR
Orforglipron1.0%2.5%3.0%
Zepbound Pen2.3%2.3%2.3%
Wegovy injectable1.6%1.6%1.6%
Week 39-52 CAGR
Orforglipron1.0%2.0%3.0%
Zepbound Pen2.4%2.4%2.4%
Wegovy injectable-2.5%-2.5%-2.5%
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 $1.1bn in low and high cases with different volume ramp assumptions. ---
Exhibit 4: Orforglipron FY26 Sales Under Low, Mid, and High Cases
Low Case
Orfor Revenue Quarterly ($mn)1Q262Q263Q264Q26FY26
of which DTC$106$225$301$632
of which commercial$90$176$207$473
of which Medicare and Medicaid$0$9$18$28
Total$196$411$526$1,133
Orfor Volume (TRx) Quarterly1Q262Q263Q264Q26
of which DTC419,619803,967989,9042,213,490
of which commercial180,120351,913413,904945,938
of which Medicare and Medicaid66238,47974,422113,563
Total600,4021,194,3591,478,2303,272,991
Mid Case
Orfor Revenue Quarterly ($mn)1Q262Q263Q264Q26FY26
of which DTC$122$368$615$1,106
of which commercial$104$287$423$813
of which government$0$16$37$53
Total$226$671$1,076$1,972
Orfor Volume (TRx) Quarterly1Q262Q263Q264Q26
of which DTC482,9471,311,1362,022,2373,816,319
of which commercial207,370573,218845,6931,626,282
of which government91764,178152,403217,498
Total691,2341,948,5323,020,3335,660,099
High Case
Orfor Revenue Quarterly ($mn)1Q262Q263Q264Q26FY26
of which DTC$133$501$948$1,581
of which commercial$113$389$651$1,153
of which Medicare and Medicaid$0$22$58$79
Total$247$911$1,656$2,814
Orfor Volume (TRx) Quarterly1Q262Q263Q264Q26
of which DTC526,8811,779,1753,113,7195,419,774
of which commercial226,281777,1091,302,2222,305,612
of which Medicare and Medicaid1,10788,475234,853324,435
Total754,2692,644,7594,650,7948,049,822
Source: Goldman Sachs Global Investment Research
Exhibit 5: Orforglipron TRx Scenarios for FY26 vs. Recent Obesity Launches
TRx Orfor Scenarios vs. Recent Obesity Launches
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Source: Goldman Sachs Global Investment Research ---
Exhibit 6: Orfor FY26 Projections Under Our Theoretical Low, Mid, and High Cases
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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.