Goldman Sachs analysts say the obesity drug market is entering a new phase where breadth of treatment options, rather than reliance on a single blockbuster, will determine long-term winners.
Wrapping up last week’s European Association for the Study of Diabetes (EASD) meeting, the bank highlighted three key trends.
They are the arrival of oral pills from Novo Nordisk (NYSE:NVO) and Eli Lilly and Co (NYSE:LLY), growing market fragmentation, and a pivot to next-generation therapies as GLP-1 drugs near their limits in obesity.
Eli Lilly emerged from the conference with stronger momentum, as physicians gave more positive feedback on its orforglipron data than Novo’s pill version of Wegovy.
Experts noted that even modest weight loss of 5-10% can be meaningful for many patients, with pills likely to become first-line therapy in primary care, particularly for those preferring convenience or unable to tolerate injectables.
Around 25–40% of patients may fall into this category.
With GLP-1 efficacy and side-effect profiles now well established, attention is shifting to amylin, triple agonists, and combination therapies.
Lilly’s eloralintide showed 13% weight loss in early studies and is seen as the leading next-generation amylin agent. Amgen’s MariTide also drew interest for its durability, while Novo’s cagirlintide received a cooler reception.
Goldman emphasised that fragmentation and personalisation will reshape the market, with companies needing broad portfolios to address diverse patient needs.
It expects the obesity “trade” to become harder as investor debates over market size, pricing and access remain unresolved. In the US, insurance coverage is tightening, pushing some patients into the cash-pay channel where pricing will be crucial.
Looking forward, Goldman maintains 'buy' ratings on both Lilly and Novo, but sees Lilly better positioned near term.
Key catalysts include Novo’s Alzheimer’s trials (EVOKE/EVOKE+) in Q4 and Lilly’s phase 2 eloralintide data at Obesity Week in November. The bank also flagged innovation from Chinese firms, with several novel GLP-1 and multi-agonist agents presented at EASD.
For investors, Goldman’s message is clear: the obesity market is no longer defined by a single theme.
Success will depend on differentiated science, breadth of offering, and careful navigation of pricing and reimbursement pressures.