Semaglutide generates $36.1 billion in annual sales, entering the second half of the global "King of Drugs" battle

21st Century Business Herald Reporter Ji Yuanyuan reports

On February 3rd, Novo Nordisk released its 2025 financial report. Data shows that Novo Nordisk’s full-year revenue reached 309.064 billion Danish kroner (approximately $48.9 billion), a 6% year-over-year increase, with a net profit of 102.434 billion Danish kroner (about $16.2 billion), up 1% year-over-year. Among them, semaglutide, as the “flagship product,” contributed $36.1 billion in sales, an increase of over 10%.

A securities analyst in the pharmaceutical industry told 21st Century Business Herald that overall, Novo Nordisk remains a leader in the global diabetes and obesity treatment fields, but its growth rate has slowed compared to previous years, indicating that policy environments pose challenges to the profitability models of high-priced innovative drugs.

For example, Tirzepatide’s sales in the first three quarters reached $24.8 billion, rapidly narrowing the gap with semaglutide’s full-year sales of $36.1 billion. By 2025, who will be the “king of drugs” worldwide? A new battle has already begun around weight loss quality, administration methods, and global markets.

“Novo Nordisk will still dominate the GLP-1 field in 2025, but the growth slowdown and policy pressures are becoming apparent. In the future, it needs to consolidate its advantages in the weight loss market while accelerating the layout of oral formulations and emerging indications,” said the analyst. Global competition will present a three-dimensional game of “efficacy + price + channels,” with Eli Lilly’s Tirzepatide being the most formidable challenger to Novo Nordisk’s semaglutide, and the rise of Chinese companies may change the market landscape in the medium term.

“Flagship” Products as Growth Engines

Major multinational pharmaceutical companies have been actively deploying products, striving to continuously launch generation after generation of “internet-famous” products through strong R&D capabilities. From the current market performance, GLP-1 has emerged as a next-generation “king of drugs” after PD-1, attracting industry attention.

IQVIA data shows that since the launch of new GLP-1 agonists in 2021, sales of prescription drugs for obesity have increased significantly. By 2031, sales of these drugs are expected to exceed $17 billion, with a compound annual growth rate of 15.6% from 2021 to 2031. This growth trend aligns with other forecasts from market research firms. For example, IQVIA Holdings predicts that by 2027, U.S. expenditure on obesity drugs will reach $10 billion, an increase of over 378%.

Assuming a patient only receives one obesity prescription drug at a time, the number of patients treated with obesity drugs in the seven major markets in 2022 is estimated at 3.1 million. This is far from the approximately 150 million obese patients in these countries (assuming an average of 19.3% of the population), indicating a large group of untreated obese patients, and suggesting that the prescription treatment rate for obesity still has room for improvement. Currently, in these seven markets, GLP-1 agonists are expected to treat 27% of patients.

According to Novo Nordisk’s disclosures, the full-year sales of all semaglutide products reached 228.288 billion Danish kroner (about $36.1 billion). The glucose-lowering injectable Ozempic (brand name NovoThrive domestically) sold 127.089 billion Danish kroner (about $20.1 billion), the weight-loss injectable Wegovy (brand name NovoYing domestically) sold 79.106 billion Danish kroner (about $12.5 billion). The oral form of glucose-lowering semaglutide (brand name NovoXin domestically) sold 22.093 billion Danish kroner (about $3.5 billion). Since its US launch on January 5, Wegovy oral tablets (25mg once daily) have accumulated about 50,000 prescriptions weekly.

It is reported that Novo Nordisk has submitted a supplemental new drug application (sNDA) to the U.S. Food and Drug Administration (FDA) for a 7.2mg weight-loss version of semaglutide injection. Meanwhile, Novo Nordisk is awaiting approval results for new therapies, including the hemophilia treatment Mim8 and the obesity treatment CagriSema.

In China, Novo Nordisk leads the GLP-1 market for diabetes treatment and the insulin market, maintaining high growth in obesity and rare disease markets. The China region’s revenue was 18.658 billion Danish kroner (about $2.829 billion).

“The core growth driver for Novo Nordisk remains GLP-1 drugs, especially the rapid volume increase in weight-loss indications, but policy and pricing pressures will test its future profit margins,” the analyst said. On one hand, GLP-1 drugs show significant efficacy in lowering blood sugar and weight loss, with rapidly expanding market size. As more companies enter this track, competition intensifies; on the other hand, in March 2026, the core patent for semaglutide will expire, and domestic generic manufacturers are expected to enter the market on a large scale, risking market share erosion for original drug makers.

Additionally, regarding insurance policy impacts, national medical insurance negotiations are driving drug price adjustments. In the market, GLP-1 prices have fallen sharply, further intensifying competition among products in this track. In fact, since November 2025, Novo Nordisk and Eli Lilly have sequentially reduced the prices of semaglutide and tirzepatide, with semaglutide dropping to 199 yuan/month and tirzepatide to 299 yuan/month. Previously, GLP-1 weight-loss drugs once reached thousands of yuan per month.

Domestic and International Pharma Compete for GLP-1

Currently, the global GLP-1 market has formed a duopoly between Novo Nordisk and Eli Lilly, with combined product revenues approaching $50 billion in 2024.

Semaglutide’s 2025 full-year sales reached $36.1 billion, surpassing Merck’s Keytruda (pembrolizumab). According to Merck’s financial disclosures, Keytruda’s annual sales first exceeded $31.68 billion. This means semaglutide currently ranks first in global drug sales.

However, Eli Lilly’s tirzepatide is also growing rapidly, with the drug alone generating $24.837 billion in revenue in the first three quarters, accounting for 54% of Eli Lilly’s total revenue. Notably, the prescription share of tirzepatide versus semaglutide in the US market further widened in Q3 2025, with tirzepatide at 57.9% and semaglutide at 41.7%.

Moreover, the competition between the two giants has expanded from product sales to comprehensive rivalry. In September 2025, at the European Society of Cardiology (ESC) annual meeting, Novo Nordisk announced the latest data from the STEER real-world study. The study, based on real patient medication experiences, evaluated the effectiveness of Wegovy (semaglutide 2.4mg) versus tirzepatide in preventing major adverse cardiovascular events (MACE) in overweight or obese patients with established cardiovascular disease but no diabetes.

Results showed that, among all treated patients, regardless of medication interruption, semaglutide reduced the risk of heart attack, stroke, and all-cause death by 29% compared to tirzepatide. The average follow-up time was 8.3 months for the semaglutide group and 8.6 months for the tirzepatide group.

Additionally, in patients with overweight or obesity and established cardiovascular disease (CVD), continuous treatment with semaglutide reduced the risk of heart attack, stroke, and all-cause death by 57% compared to tirzepatide.

Besides the competition between the two giants, domestic pharmaceutical companies are also active in this track. According to the Nextpharma database, there are currently 88 small-molecule GLP-1 drugs in clinical development worldwide, with 6 in Phase III trials, including Eli Lilly’s Oxfogliptin, Hengrui Medicine’s HRS-7535, Wentai Medicine’s VCT220, Biomed Industries’ Bionetide, Huadong Medicine’s Conveglipron, and Derui Zhiyao’s MDR-001.

The aforementioned analyst said that the GLP-1 track has transitioned from an early “blue ocean” market to a new stage of “factional competition.” The current market pattern is dominated by Novo Nordisk and Eli Lilly, but there is still significant room for differentiated innovation, especially in clinical needs such as preventing weight rebound and muscle loss in weight-loss drugs.

“From a development trend, GLP-1 drug innovation is moving toward multi-target, longer-acting, and more convenient administration methods. Oral formulations have become the industry’s next core competitive focus, and expanding indications remains an important strategy for prolonging product lifecycle,” the analyst added.

Big Players Seek New Growth

Under the dual pressures of U.S. pricing legislation and global competition, Novo Nordisk urgently needs to break through.

To address this challenge, Novo Nordisk has previously disclosed that it is actively building a defense system. Public information shows that the company is investing heavily in expanding NovoCare pharmacies and other direct-to-patient plans, and deepening cooperation with telemedicine institutions to bypass traditional distribution barriers and directly reach patients.

On the payment side, Novo Nordisk has also achieved key victories. Starting July 1, 2025, Wegovy became the only GLP-1 drug for obesity covered on CVS’s national formulary. This exclusive agreement is expected to significantly improve Wegovy’s accessibility through insurance channels. In terms of pricing strategies, Novo Nordisk launched new patient acquisition plans such as the “Wegovy $499 Plan” to lower out-of-pocket costs and compete with combination drugs.

Internal cost-cutting and efficiency measures have also begun. In September 2025, Novo Nordisk announced a large-scale restructuring plan, aiming to cut about 9,000 jobs globally, including approximately 5,000 in Denmark.

Novo Nordisk stated that the savings will be used to fund growth opportunities in diabetes and obesity, including commercial execution plans and R&D projects.

In fact, in the Chinese market, Novo Nordisk’s semaglutide performed steadily in 2025, though growth was moderate. Data shows that three brands of semaglutide are listed and sold in China: the glucose-lowering injection Ozempic (sales of 5.399 billion Danish kroner, about $818 million), the oral glucose-lowering Rybelsus (sales of 620 million Danish kroner, about $94 million, up 27%), and the weight-loss injection Wegovy (sales of 796 million Danish kroner, about $121 million), up 314%.

Before the financial report release, there was also news of leadership changes in China. Novo Nordisk China’s official WeChat account announced that Christine Zhou, the global Senior Vice President and President of Greater China, will leave Novo Nordisk, with her last working day on March 31, 2026. Yan Cai was appointed as the new Senior Vice President and President of Greater China.

On February 4, 2026, market sources reported that Zhou Hong, Executive Vice President of Merck Healthcare and Head of China and International Markets, will leave to become Vice President of Product and Portfolio Strategy at Novo Nordisk, while Ludovic Helfgott, the former executive at Novo Nordisk, announced his departure. A related person confirmed to 21st Century Business Herald that this news is accurate.

Currently, as the global “king of drugs” competition intensifies, the sales gap between semaglutide and tirzepatide has narrowed to less than $2 billion. The comprehensive competition in indications expansion, administration innovation, and market expansion between these two giants will determine the final landscape of the GLP-1 track in the coming years.