Ozempic maker Novo Nordisk is at risk of losing its weight-loss crown as rivals crowd into the obesity drug space, offering drugs that are being sold to Australians as cheaper and more effective.
One major competitor, Eli Lilly, confirmed that its blockbuster weight loss drug Mounjaro was Australia’s highest-selling brand of prescription medication last year across all categories.
Novo, the $284 billion Danish obesity drug pioneer, shocked the financial market on Tuesday after forecasting a 13 per cent decline in sales this year as an obesity drug price war hits its bottom line, sending its shares 15 per cent lower.
In Australia, online weight loss clinics are prescribing Mounjaro and awaiting the development of a next-generation formula called retatrutide that has inspired such fervour that knock-off versions are being imported from China.
One senior industry source, who spoke on condition of anonymity, said Eli Lilly was ahead on weight loss, but Novo Nordisk had better drug delivery methods, such as a pill form of Ozempic sold under the Wegovy brand, and fewer side effects.
“The interesting battle at the heart of the story is does weight loss matter or delivery,” the source said.
That Novo Nordisk, which pioneered the contemporary weight-loss drug category in the 2020s, is facing such competition has resulted in a massive cut to its share price. It had hit a market capitalisation of $US400 billion ($569 billion) in 2023, making it Europe’s largest company by valuation and worth more than the entire GPD of its home country, Denmark.
Chief executive Mike Doustdar said in a statement that: “In 2026, Novo Nordisk will face pricing headwinds in an increasingly competitive market.
“However, we are very encouraged by the promising early uptake from the US launch of Wegovy pill, and we remain confident in our ability to drive volume growth over the coming years,” he added.
One investor, ArthaScope’s Lars Hytting, told Bloomberg that “even the most sceptical analyst” didn’t anticipate this big a drop.
Novo will also be hit by steep discounts to Ozempic and Wegovy in 2027 as part of Donald Trump’s push to lower pharmaceutical costs for Americans.
But in Australia, where many patients access weight-loss medications through integrated online health businesses, competition is the primary factor hitting Novo.
Novo has successfully launched Wegovy in pill form in the US. It is not available in Australia, and Eli Lilly’s Zepbound has been widely accepted as a more effective weight-loss drug.
Sold locally as Mounjaro, it is a dual agonist drug that activates two different types of receptors simultaneously to produce a stronger weight-loss effect than Novo’s Ozempic and Wegovy, which activate one receptor.
And waiting in the wings is Eli Lilly’s next-generation retatrutide, a “triple G” hormone agonist which activates three receptors to reduce appetite and improve fat metabolism. Doctors expect it to be approved by authorities this year or early next, but knock-off versions of this unproven medication are already being shipped directly to Australia, which medical professionals have warned is a major health risk.
Dr Kieran Dang, chief medical officer at online men’s health start-up Mosh, said the company has been monitoring the development of new drugs and delivery methods with interest.
It is currently prescribing Mounjaro for some patients and is closely watching retatrutide as it goes through clinical trials.
“The shift towards oral medications is also of interest,” he said. “Many Australians have an aversion to needles, and options like an oral version of Wegovy or Eli Lilly’s orforglipron could make these treatments far more accessible and easier to stick with long-term.”
A Novo spokesperson said: “We are working towards making the Wegovy pill available in Australia as part of our commitment to bringing innovations in obesity treatment for Australian patients. We look forward to sharing more details in due course.”
Tim Doyle, chief executive of a company called Eucalyptus that is behind weight loss brands such as Juniper and Pilot, said: “The pipeline of transformative medications in this category is incredibly exciting. Both form factor and efficacy innovations are ultimately wins for patients with obesity.”
An Eli Lilly spokeswoman said: “Lilly is seeking Australian registration of its next-generation obesity management medicine, orforglipron, with the TGA recently accepting an application for registration.”
“Mounjaro was the highest-selling prescription medicine brand in Australia in 2025.”
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Colin Kruger is a senior business reporter for the Sydney Morning Herald and The Age.Connect via email.
Nick Bonyhady is the business editor of The Sydney Morning Herald and The Age. He is a former deputy federal editor, technology editor and industrial relations reporter.Connect via X or email.