Eli Lilly and Novo Nordisk are the undisputed leaders in the market for GLP-1 drugs, a class of medications used to treat both diabetes and obesity.

Semaglutide Sales

Novo Nordisk's semaglutide generated significant revenue in 2024, totaling DKK 201.84 billion (approximately USD 29.3 billion). [1] This impressive figure represents 70% of the company's overall revenue for the year. A breakdown of semaglutide sales reveals the following:

• ◆ Ozempic (diabetes injection): DKK 120.34 billion (USD 17.47 billion), a substantial 26% increase year-over-year.

• ◆ Rybelsus (oral diabetes medication): DKK 23.3 billion (USD 3.38 billion), also demonstrating strong growth with a 26% increase year-over-year.

• ◆ Wegovy (weight loss injection): DKK 58.2 billion (USD 8.45 billion), exhibiting remarkable growth with an 86% increase year-over-year (Figure 1).

Figure 1. Sales of Semaglutide in 2024 [1]

Semaglutide's remarkable success underscores the effectiveness of Novo Nordisk's strategic approach, which centers on two key pillars. First, the company has strategically diversified its formulations, offering both subcutaneous injections and an oral option, thereby expanding patient access and improving the treatment experience. Second, Novo Nordisk has aggressively pursued label expansion, fully realizing semaglutide's therapeutic potential. Following its initial approval for type 2 diabetes, semaglutide has emerged as a leading therapy for weight management and has demonstrated efficacy in reducing cardiovascular events and mitigating kidney disease. Further potential indications, including Alzheimer's  and MASH (metabolic dysfunction-associated steatohepatitis), are also being investigated.

Figure 2. Semaglutide pipelines

1.    Obesity Management:

• The STEP UP trial demonstrated significant weight loss with semaglutide 7.2mg, with participants losing 20.7% of their body weight after 72 weeks, compared to 17.5% with the 2.4mg dose and only 2.4% with placebo. In addition, 33.2% of those who received semaglutide 7.2 mg achieved a weight loss of 25% or more after 72 weeks, compared to 16.7% with semaglutide 2.4 mg and 0.0% with placebo. [2]

2. Cardiovascular Protection:

• Subgroup analysis of the SELECT trial indicated that semaglutide reduces cardiovascular event risk regardless of prior coronary artery bypass grafting (CABG) history.

• The FLOW trial demonstrated that semaglutide significantly reduces the risk of major kidney endpoints in patients with type 2 diabetes and chronic kidney disease, irrespective of baseline cardiovascular status.

• The SOUL study showed that adding oral semaglutide to standard care reduces the risk of major adverse cardiovascular events (MACE) by 14% in patients with type 2 diabetes and established cardiovascular or kidney disease.

3. Kidney Disease Management:

• In January 2025, the FDA approved semaglutide to reduce the risk of worsening kidney disease and cardiovascular death in adults with type 2 diabetes and chronic kidney disease. [3]

4. NASH Treatment:

• The ESSENCE trial shows that 37.0% of people treated with semaglutide 2.4 mg achieved improvement in liver fibrosis with no worsening of steatohepatitis compared to 22.5% on placebo. 62.9% of people treated with semaglutide 2.4 mg achieved resolution of steatohepatitis with no worsening of liver fibrosis compared to 34.1% on placebo. [4]

Tirzepatide Sales

While launched over four years after semaglutide, tirzepatide has experienced explosive growth. In 2024, the combined sales of tirzepatide's diabetes and weight-loss formulations reached $16.46 billion, representing approximately 36% of Eli Lilly's total revenue. Specifically:

• ◆ Mounjaro (tirzepatide for diabetes): Achieved blockbuster status in 2024, exceeding $10 billion in sales for the first time and reaching $11.54 billion, a remarkable 124% year-over-year increase. (Figure 2)

• ◆ Zepbound (tirzepatide for weight loss): Generated $4.92 billion in revenue in its first full year. Zepbound launched in the US in November 2023 for adults with obesity or overweight with at least one weight-related comorbidity.

Figure 3. Sales of tirzepatide in 2024 [5]

Eli Lilly's tirzepatide has received FDA approvals for diabetes, weight loss and obstructive sleep apnea (OSA). And it is currently being studied for heart failure with preserved ejection fraction (HFpEF), cardiovascular risk reduction, and metabolic dysfunction-associated steatohepatitis (MASH), etc.

• Diabetes: In May 2022, the FDA approved tirzepatide (Mounjaro) for improving blood sugar control in adults with type 2 diabetes, in conjunction with diet and exercise.

• Weight Loss: In November 2023, tirzepatide (Zepbound) was approved for weight loss and maintenance of weight loss in adults with obesity or overweight.

• Obstructive Sleep Apnea (OSA): In December 2024, the FDA approved Zepbound for improving snoring in obese patients with moderate to severe OSA, making it the first and only prescription medication approved for this sleep disorder. [6]

• Superior Weight Loss Compared to Semaglutide: Clinical trial results (SURMOUNT-5) showed that tirzepatide led to 47% greater average weight loss compared to semaglutide (Wegovy) over 72 weeks. Participants on tirzepatide experienced an average weight loss of 20.2%, while those on semaglutide lost an average of 13.7%. Tirzepatide also demonstrated superiority in study endpoints in obese or overweight adults without diabetes. [7]

Figure 4. Tirzepatide pipelines

References:
[1]https://www.novonordisk.com/content/dam/nncorp/global/en/investors/irmaterial/annual_report/2025/novo-nordisk-annual-report-2024.pdf
[2] https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=915087
[3] https://www.novonordisk-us.com/media/news-archive/news-details.html?id=915253
[4] https://www.novonordisk.com/news-and-media/news-and-ir-materials/news-details.html?id=171971
[5] https://investor.lilly.com/news-releases/news-release-details/lilly-reports-full-q4-2024-financial-results-and-provides-2025
[6] https://investor.lilly.com/news-releases/news-release-details/fda-approves-zepboundr-tirzepatide-first-and-only-prescription
[7] https://www.lilly.com/en-CA/news/press-releases/2024.12.4-tirzepatide-surmount-5-h2h