Novo Nordisk’s Oral Wegovy Pill Surges Past Eli Lilly, but Generics and Price Pressure Loom

Novo Nordisk's oral Wegovy pill leads Eli Lilly's Foundayo 2-to-1 in US prescriptions, but faces generic competition in Canada and a grim 2026 revenue forecast.

The battle for supremacy in the weight-loss drug market is taking a sharp turn. While Novo Nordisk’s new oral Wegovy pill is trouncing Eli Lilly’s rival offering in the US, the Danish pharma giant faces a growing storm from generic competition in Canada and a grim full-year outlook that has already slashed a fifth off its share price.

Pill Power: A Two-to-One Lead

Data from Citigroup paints a clear picture of dominance in the oral GLP-1 race. By the 15th week on the US market, Novo Nordisk’s tablet had racked up roughly 124,000 prescriptions, growing at a weekly clip of 10%. That is nearly double the volume seen by Eli Lilly’s new entrant, Foundayo, which launched in early April 2026 and managed just 1,390 scripts in its first week—a fraction of the 3,000-plus Novo Nordisk recorded at its own launch in January.

Crucially, the pill is not cannibalizing sales of Novo Nordisk’s injectable Wegovy. Instead, it is generating entirely new revenue, a sign that the oral format is expanding the market rather than just shifting patients from one delivery method to another.

A Buyback to Counter the Headwinds

The market took note. While Eli Lilly’s shares slipped, Novo Nordisk’s US-listed American depositary receipts rallied in late April, and the euro-denominated stock has clawed back nearly 14% over the past 30 days. The shares now trade at around €35.09, though that recovery comes from a deep hole—the stock is still down roughly 21% year to date, far from its historic highs.

Management is trying to shore up confidence. On April 27, the company confirmed it had bought back over 13 million shares for 3.44 billion Danish kroner, part of a broader 15 billion kroner buyback program. The timing is no accident. Novo Nordisk is bracing for a tough year, forecasting a revenue decline of between 5% and 13% in 2026, weighed down by pricing pressure from US health programs and hefty restructuring costs.

Canada Opens the Generic Floodgates

The biggest long-term threat may be coming from Canada. Health authorities there have approved the first generic version of semaglutide, the active ingredient in Ozempic and Wegovy, from Dr. Reddy’s Laboratories. The original Ozempic patent expired in Canada back in January, and the arrival of generics typically triggers a brutal price collapse—initial copies often launch at 75% to 85% of the brand price, but once three or more competitors enter, prices can tumble to around 35% of the original. With eight more generic applications under review, the race to the bottom is accelerating.

What to Watch Next

Investors have two key dates on the calendar. Eli Lilly reports its quarterly results on April 30, offering the first hard data on how Foundayo is faring. Then on May 7, Novo Nordisk opens its own books, giving the market its first official financial update under the new, downbeat annual guidance. Analysts will be watching for two things: how well the oral Ozempic pill is gaining traction in the US, and any details on the planned label expansion for children and adolescents, expected in the second half of the year.

For now, Novo Nordisk has a clear lead in the pill market, but the headwinds from generics, pricing pressure, and a weak balance sheet are not going away. The buyback is a signal of intent, but it will take more than share repurchases to reverse a 21% year-to-date slide.