Novo Nordisk’s Oral Pill Crushes Lilly’s Foundayo in Prescription Race, but a 50% Stock Rout Tells a Darker Story

Eli Lilly's Foundayo trails Novo Nordisk's oral Wegovy in weekly scripts; Novo faces stock slump but scores pediatric diabetes win with oral semaglutide.

The numbers tell a stark tale of two very different trajectories. In its second week on the US market, Eli Lilly’s newly approved oral weight-loss capsule Foundayo managed just 3,707 prescriptions. That figure was already a sharp improvement from its 1,390-prescription debut, but it paled next to the 18,410 scripts written for Novo Nordisk’s oral Wegovy pill during the same period. Deutsche Bank analyst James Shin had penciled in roughly 8,000 Foundayo prescriptions as the minimum needed to keep pace with Novo Nordisk’s offering — a bar the Lilly drug fell well short of.

RBC analyst Trung Huynh urged caution, noting that early weekly data can be volatile. Lilly itself acknowledged that not all pharmacy partners may have been captured in the figures. The FDA has also mandated post-market studies on potential liver damage, though Lilly insists its late-stage trials found no such signals.

Yet for all the commercial momentum in the oral GLP-1 space, Novo Nordisk’s stock tells a far grimmer story. The shares have lost roughly 24% since the start of 2026, and from a 52-week high of €70.13, they now trade at €35.16 — a decline of nearly 50%. The relative strength index has sunk to 17.8, a technically oversold level that typically signals extreme bearishness. The pain traces back to February, when Novo Nordisk issued its first profit warning in nine years, forecasting a 5% to 13% decline in both revenue and operating profit for 2026 on a currency-adjusted basis. That came after 10% revenue growth in 2025, marking a dramatic reversal.

Teen Trial Opens a New Front

Amid the financial headwinds, Novo Nordisk scored a clinical win that could unlock an entirely new patient population. On April 24, the company released positive Phase 3a data from the PIONEER TEENS study, which tested oral semaglutide in children and adolescents aged 10 to 17 with type 2 diabetes. After 26 weeks, the treatment delivered a 0.83 percentage point greater reduction in HbA1c compared with placebo, with a safety profile consistent with adult studies. It marks the first time an oral GLP-1 receptor agonist has been successfully trialed in a pediatric setting.

The potential market is significant: roughly 364,000 people under 20 in the US alone live with diabetes. Novo Nordisk plans to file for regulatory approval in the US and Europe during the second half of 2026. Oral semaglutide is already sold as Rybelsus, but the company intends to launch it as the Ozempic pill in the US during the second quarter of 2026.

Pricing Pressure and the Lilly Threat

The company’s outlook remains clouded by what management describes as “noticeable” pricing headwinds in the US for 2026. These include lower net prices, reduced Medicaid reimbursements for obesity treatments, and the impact of the Most-Favored-Nations pricing rule. The competitive landscape is also intensifying. Lilly’s Foundayo, priced between $149 and $349 per month for self-pay patients, adds direct pressure on pricing. Viking Therapeutics is advancing its dual agonist VK2735 through Phase 3 trials, showing impressive weight reduction data.

The broader obesity drug market is projected to grow from roughly $26 billion in 2025 to over $133 billion by 2031 — a pie that is expanding rapidly but attracting more players to the table.

What’s Next

Novo Nordisk will report its quarterly earnings before the market opens on May 6, 2026. The prescription data and the PIONEER TEENS success give the company a strong narrative: its oral GLP-1 pipeline retains commercial and clinical momentum despite the arrival of a new competitor. But the February profit warning and the 50% stock decline have reset expectations dramatically.

Lilly reports its own quarterly results on April 30, which could move the entire GLP-1 sector and offer a clearer picture of how competitive pressure is actually landing on Novo Nordisk. Meanwhile, the Danish drugmaker is also preparing regulatory submissions for oral semaglutide in a 7.2 mg dose and for the combination therapy CagriSema — both of which could reshape the narrative if approved.