Novo Nordisk (NYSE:NVO) has intensified its rivalry with Eli Lilly (NYSE:LLY), releasing a provocative cross-trial analysis that claims its experimental Wegovy pill is both more effective and better tolerated than Lilly’s recently approved obesity tablet, Foundayo.
The study, dubbed ORION, utilized a population-adjusted indirect treatment comparison to bridge the gap between separate Phase 3 clinical trials.
According to the findings, a 25 mg dose of Novo’s oral semaglutide resulted in 3.2 percentage points more weight loss than a 36 mg dose of Lilly’s orforglipron (marketed as Foundayo).
Perhaps more critically for long-term patient adherence, the study indicated that patients on Foundayo had roughly 14 times higher odds of discontinuing treatment due to gastrointestinal side effects compared to those on the Wegovy pill.
The data release marks a preemptive strike by Novo as the two pharmaceutical giants pivot from injectable weight-loss treatments to the more convenient oral "pill" market.
While Novo’s injectable Wegovy and Lilly’s Zepbound have dominated headlines, the next frontier of the multi-billion dollar obesity market hinges on oral delivery, which promises easier distribution and higher patient uptake.
The two treatments offer a distinct trade-off between efficacy and lifestyle flexibility.
Lilly’s Foundayo is a non-peptide molecule that carries no food or timing restrictions, a feature CEO Dave Ricks has touted as a major convenience advantage.
In contrast, the Wegovy pill must be taken on an empty stomach with a small sip of water, followed by a 30-minute fast.
Despite these requirements, a separate Novo-sponsored preference study, OPTIC, claimed that 84% of surveyed U.S. adults would choose the Wegovy profile over Foundayo’s, citing the perceived superior weight loss and safety results.
Lilly has yet to issue a formal rebuttal to the ORION data, though researchers note that indirect comparisons carry inherent limitations.
Novo acknowledged that while they adjusted for baseline weight and sex, unaccounted-for variables in trial design could influence the results.
The full findings are expected to be the centerpiece of the Obesity Medicine Association’s annual conference in San Diego on April 10.