With the oral GLP-1 pill orforglipron, Eli Lilly has taken a decisive step towards market approval. In a pivotal study, the preparation achieved all primary and secondary goals in type 2 diabetics: In addition to significantly lowering blood sugar, it reduced body weight by an average of around 7.9% or 16 pounds – without a plateau effect at the end of the study after 40 weeks.

The results could reorder the market for obesity and diabetes medications. Unlike existing injectable GLP-1 preparations like Lilly's Mounjaro or Novo's Ozempic and Wegovy, orforglipron is an orally administered small molecule compound. This offers several advantages: larger production capacities, better storage and transport conditions, as well as simplified intake without the need for a cold chain or fear of injections. The preparation is also likely to be more accessible in global markets without stable logistics structures.

The potential to reach new patient groups is enormous," says Jeffrey Emmick, Senior Vice President for Product Development at Lilly Cardiometabolic Health. For many patients, the threshold for injection is simply too high – a daily pill could be the breakthrough here.

While Novo's Rybelsus is already a semaglutide-based oral medication for diabetes treatment, Lilly is relying on a different molecular approach with orforglipron. As a small molecule, the active ingredient can be absorbed more quickly and does not have the strict food and fluid restrictions that apply to Rybelsus.

The recent study included only type 2 diabetics; data on the application for obese patients is expected to follow later this year. Analysts already expect the new drug to generate billions in sales. The global market for obesity therapies, dominated by Novo Nordisk and Lilly, could reach a volume of over $100 billion by 2030, according to estimates.

Lilly aims to apply for market approval of orforglipron for weight loss by the end of the year, with the diabetes indication application to follow next year. If the drug is approved, it could significantly expand access to GLP-1 therapies and challenge the dominance of injectable drugs.