Is it back to square one for Eli Lilly?

After a series of setbacks for Novo Nordisk, Eli Lilly had almost lost sight of the Danish group in its rearview mirror. But the tide could be turning. The results of the study on the oral version of its obesity treatment are in, and they are very disappointing.

Before returning to this topic, a word on financial performance. The group had an excellent quarter. In a politically turbulent sector, Eli Lilly's share price experienced record volatility in 2025: 38.3%, the highest since 1972, its second year of listing. While the share price has been stable over the past year, the laboratory has strengthened its credibility.

Eli Lilly is now seen as the leader in the highly coveted obesity market, estimated to be worth $150bn by 2030. According to IQVIA data, Zepbound prescriptions now account for 60% of all prescriptions. This is particularly significant given the clear political trend towards "Made in America," which could give Eli Lilly an advantage over its European competitor.

In the second quarter, adjusted earnings per share jumped 61% to $6.31, well above expectations. Revenue reached $15.6bn, driven by strong demand for Zepbound and Mounjaro. The latter, indicated for the treatment of type 2 diabetes, generated $5.20bn in sales, compared with $4.74bn anticipated. Zepbound, approved for obesity, reached $3.38bn, again above forecasts.

On the strength of these results, Eli Lilly has slightly raised its annual revenue forecast, which is now expected to be between $60bn and $62bn (up from $58bn to $61bn previously).

But the pill is hard to swallow

The enthusiasm surrounding the results quickly evaporated after publication. This was due to disappointing results for Orforglipron, its anti-obesity pill. Until now, studies have shown that Eli Lilly's injectable treatments outperform those of Novo Nordisk.

But the future of the sector seems to lie in oral forms, which are easier to produce, distribute, and administer. Not to mention the aversion to needles, which deters many potential patients.

Novo Nordisk has a head start in this area. In March 2025, the group filed an application for approval for its anti-obesity pill, with a response expected by the end of the year. The initial results are promising: at high doses, the oral version of Wegovy achieves an average weight loss of 15%, without dietary restrictions and with fewer patients dropping out of treatment.

With orforglipron, patients lose an average of only 12% of their weight after 72 weeks. The dropout rate is higher than estimated: 24.4% at the highest dose and 15% at lower doses. The main side effect? Vomiting, which affects a quarter of patients, is the main cause of premature discontinuation.

The full results will be published next month. The group still plans to submit an application for approval to the FDA by the end of 2025.