Millions of Americans need to decide whether to give up on new weight loss pills or move to a more expensive branded version.
Novo Nordisk and Eli Lilly were unable to keep up with the demand for new blockbusters of Wegovy and Zepbound, an unusually large market for the “composite” version developed after FDA medical regulators declared an official shortage in 2022.
Combined drugs are custom made by pharmacies using the active ingredients of patented drugs. Over the past two years, patients have been able to purchase a combined version of Novo ingredients, Semaglutide and Lilly’s tilzepatide for just $199 a month. The US prices charged to people without insurance range from $1,000 to $1,300 for brand drugs.
But the FDA now says the shortage is over. Larger combined pharmacies that usually produce small amounts of drugs that are supply or adapted to the patient’s specific needs have already been told to stop selling versions of Zepbound, and are compounding Wegovy until May 22nd.
Advertisement for combined drugs. The Industry Association estimates that patients with 2MN were in a combined version of weight loss medication in the year until November 2024 ©HERS/YOUTUBE
The Industrial Association estimates that patients with 2MN were in a combined version of weight loss medication in the year until November 2024. Investors are looking at how they react, especially if they choose Novo’s Wegovy or Lilly Drug Zepbound.
Novo has made a flight start on the US market – Wegovi was approved in the US two years before Zepbound, but recently lost his position in Lily as the drug led to reduced weight loss.
NOVO’s stock has fallen by more than 50% over the past year, but compared to Lily’s 12% increase, some analysts say NOVO may have to lower its annual sales forecast.
NOVO CEO Lars Fruergaard Jørgensen said Wegovy’s prescription was a hit in the US in 2025, acknowledging the effects of compound interest.
Some patients may delay switching, stockpile combined drugs, or stop treatment until weight gains again. Others are completely given because they don’t have insurance or can’t afford to pay more.
The larger combined pharmacy has already been told to stop selling versions of Zepbound and has Wegovy©John Zsiray/Herald Journal via the AP until May 22nd
Both Novo Nordisk and Eli Lilly launched services to beat combined patients and sold brand drugs directly to people with no insurance for around $500. Lily also sells through telehealth companies to access more patients.
Acquiring new customers is especially important for NOVO.
UBS analyst Joe Walton cites figures for the week that ends March 21, saying that Eli Lily has “rocket ship growth” with her new prescription, indicating that Lily accounted for 70% of new patients with starting doses of obesity drugs versus 30% of Novo Nordisk.
UBS previously had hoped for higher growth for NOVO.
“In our view, they’re more or less 50/50 (with Lily) and their semaglutide is a great base product and once they return to full supply, we’ll see strong formula growth.
Intron Health has downgraded Novo Nordisk to “selling,” and says it is likely that Novo Nordisk will have to warn him that he will miss this year’s revenue guidance.
Bank of America analyst Sachin Jain expects NOVO to reduce sales guidance from 16-24% growth at a constant exchange rate to 14-22%. He wrote that there was a clear lack of what patients do during a combined suspension. “We assume that many people simply drop because of their lack of coverage, and Novonordisk and Lily take away the remaining equal share.”
Novo Nordisk Chief Lars Fruergaard Jørgensen says “significant growth” that increased Wegovy prescriptions in the US in 2025 © Lars Just/ft
Regulators, including the FDA and state pharmacy committees, could take action against formulating pharmacies after deadlines, but analysts aren’t sure how active the government cuts will be as they clean up the US.
Marty McCurry, the new Food and Drug Administration director, was previously the chief medical officer of Sesame, a telehealth group that sold compound obesity drugs.
The Health and Human Services Department said it “full support efforts to regulate combined drugs in ways that prioritize patient welfare and ensure that the use of combined obesity drugs adheres to the highest standards of safety and efficacy.”
Meanwhile, Compartmers have not given up on a lucrative new market. Some compounds hope to continue selling to patients by offering doses not on the market or by adding substances like vitamins to customize the drug. Lily recently filed a lawsuit claiming that the pharmacy is falsely suggesting that their compounds are personalized and that they have not been testing their version of the drug.
Others are challenging the end of the shortage of legal combat. Lee Rosebush, an industry group lawyer and chairman of the Outsourcing Facilities Association, said the FDA should not be able to declare the shortage over without consulting entirely on-demand.
“They are now relying on manufacturers to tell them how big the supply is and how big the demand is. I think they have a bit of a bias,” he said.
