Epic scales

GLP-1s – pharma’s $100bn+ opportunity to redefine obesity treatment

The momentum behind GLP-1 receptor agonists has become impossible to ignore.
Originally developed to control blood glucose in diabetes, these therapies have surged to the forefront of obesity care, catalysing a fundamental shift in how we manage one of the world’s most pervasive health challenges.

With weight loss outcomes rivalling bariatric surgery and early data showing cardiovascular benefits, GLP-1s are not just reshaping patient expectations but are redrawing the commercial dynamics of the pharma sector.

This is in part driven by the immense commercial potential of GLP-1s. Evaluate data shows they will already have generated more than $50 billion globally by 2024. But we’re only at the beginning.

Evaluate projects the class will grow to $75 billion in 2025 and reach $161 billion by 2030 – transforming obesity into one of the largest therapeutic markets in history.

For pharmaceutical leaders, the message is clear: this is a significant opportunity, but one that comes with intensifying competition, R&D hurdles and a rapidly evolving access environment.

The rise of GLP-1s, led by Novo Nordisk’s semaglutide (Ozempic/Wegovy) and Eli Lilly’s tirzepatide (Mounjaro/Zepbound), is redefining the market. These two drugs are on track to generate $100 billion in combined annual sales in 2025.

By 2030, tirzepatide alone could reach almost $60 billion annually – that’s almost three times bigger than the peak reached by AbbVie’s auto-immune disease blockbuster Humira, and nearly double 2024 sales of Merck & Co Inc.’s cancer behemoth Keytruda ($29.5 billion).

The class as a whole is also expected to grow at a turbo-charged compound annual growth rate (CAGR) of 17% between 2024 and 2030, and to comprise 8.6% of all prescription drug sales by the end of the decade.

But this explosive growth does not come without pressure. Surging demand outpaced manufacturing capacity in 2024, prompting both Novo Nordisk and Lilly to commit billions to production expansion.

Novo Nordisk’s parent company even acquired contract manufacturer Catalent to secure injectable capacity – a new frontier for these drugs. As these supply chain issues have levelled off in 2025, both companies are expected to capitalise further on their first-mover advantage.

The success of GLP-1s in obesity has opened the door to broader cardiometabolic applications. Given their anti-inflammatory effects, these drugs are now being explored in heart failure, fatty liver disease (MASH), chronic kidney disease and even neurodegenerative conditions like Alzheimer’s.

Last year’s FDA approval of Wegovy for cardiovascular risk reduction in obese patients – and Zepbound for sleep apnoea – signals a widening clinical footprint.

The addressable market is evolving in real time. Data from late 2024 revealed promising outcomes in HFpEF, pre-diabetes prevention, osteoarthritis and MASH.  This expansion beyond weight loss presents a dual opportunity: deepen engagement by demonstrating value across comorbidities and differentiate offerings as new entrants challenge the current mainstays in Lilly and Novo.

While Novo Nordisk and Lilly currently dominate, the next generation of GLP-1 therapies is on the horizon – and competition is heating up. More than a dozen companies are racing to enter the space, including Pfizer, Amgen, AstraZeneca, Boehringer Ingelheim and Roche.

Many are investing in combination therapies and next-generation modalities to stand out, though the R&D challenge here is significant.

One breakthrough to watch: oral GLP-1s. Just last month Lilly’s orforglipron became the first non-peptide oral GLP-1 to succeed in phase 3 trials: ‘orals like orforglipron could dramatically expand patient uptake among those resistant to injections’.

Meanwhile, Novo’s oral semaglutide (Rybelsus) already generated over $3.4 billion in 2024, validating market appetite for oral delivery, whilst Novo had recently filed for an oral version of semaglutide with the FDA with a decision expected by the end of the year.

Side effects, intolerance, premature withdrawals and inadequate weight loss associated remain a concern with currently available GLP-1s.

This has influenced an acceleration in innovation at the molecule level. Lilly’s triple agonist (GLP-1/GCG/GIP) retatrutide and Amgen’s long-acting GLP-1/GIP conjugate ‘MariTide’ aim to improve efficacy. Other emerging modalities and combinations are also coming to the frontline but have had mixed results.

Novo Nordisk’s amycretin (amylin/GLP-1) combo, cagrilintide/semaglutide, expected to achieve weight loss similar to semaglutide but with improved tolerability, hit a setback in late 2024, but the company remains committed to its amylin-based strategy.

Lilly is also investing in next-gen approaches co-administering tirzepatide with its own amylin, eloralintide, or even with bimagrumab, an anti-activin, the latter of which aims to spare lean mass and drive greater fat loss.

Roche jump-started its race in obesity investing over $5 billion in a collaboration with Zealand Pharma for its amylin, petrelentide, to be combined with its own GLP-1. The race is no longer just about ‘who got there first’ – it’s about ‘who can sustain differentiation over the next decade’.

Although few major launches are expected in 2025, it will be a pivotal year for pipeline readouts and positioning. We have already seen positive data for Lilly’s orforglipron (oral GLP-1) and further data is expected for retatrutide (triple agonist). China’s Innovent may also secure local approval for mazdutide, underscoring the global nature of this therapeutic race.

The pipeline is vast. 16 novel weight-loss drugs could enter the market by 2029, pushing the category toward a $150 billion valuation. With this influx, payer scrutiny will intensify – and players must be ready to defend or win market share with clear clinical and economic value.

As attention turns from clinical promise to real-world adoption, market access is becoming the key determinant of commercial success.

Despite strong demand, payer coverage remains inconsistent – especially in the US, where Medicare does not yet cover anti-obesity drugs, and ‘around a third of health plans exclude them altogether’ according to MMIT.

That’s starting to change. Large employer coverage of obesity treatments is set to exceed 70% in 2025, up from 67% in 2024.

Pharmacy benefit managers are negotiating exclusive deals (e.g. CVS and Novo Nordisk), and manufacturers are stepping up with copay assistance and discounted cash-pay programmes to bridge coverage gaps.

However, pricing pressure is mounting – Medicare price negotiations are likely to affect diabetes indications of GLP-1s first, with potential spillover into other areas. And in Europe, patients are increasingly paying out-of-pocket. Governments are evaluating whether broader reimbursement can be justified by long-term health system savings.

For market leaders, 2025 is about execution: increasing manufacturing scale; building new indications or treating diseases more effectively; and preparing for eventual generic threats.

Novo and Lilly are already entrenching their lead with payer agreements, direct-to-consumer price reductions and an exciting list of R&D developments. Legal and regulatory strategies, such as pushing back against compounded versions of their drugs or even collaboration with them, are also in play.

For challengers, the imperative is differentiation. That could mean superior efficacy, more tolerable side-effect profiles, less frequent dosing, or targeting niche indications where they can be first to market. M&A could also be on the rise, as partnerships may be the most efficient path to entry. The pressure for many pharma majors to ‘get in on the act’ is surely immense.

More broadly, GLP-1s have ushered in a new model for obesity care – one grounded in biology, driven by data and propelled by commercial alignment. As 2025 unfolds, the sector will be shaped by the interplay of clinical innovation, commercial dynamics and global demand.

The companies that succeed won’t just tap into a $100 billion market but will help reshape healthcare outcomes for millions.

Paul D’Souza is Senior Consultant at Evaluate