Weight loss drugs enter a new stage of "exchanging price for volume": the trend of consumerization accelerates, and low prices will stimulate a huge release of demand

The global weight loss drug market is undergoing a profound transformation, with price-for-volume strategies and consumerization trends reshaping the market landscape.

According to news from the Chasing Wind Trading Desk, a report released by Goldman Sachs on December 8 indicates that the pricing agreements recently reached by Eli Lilly and Novo Nordisk with the Trump administration are the main catalysts for this change. These agreements will significantly lower the prices of key GLP-1 drugs such as Zepbound and Wegovy starting in 2026, with the most notable development being the opening of coverage for these drugs under the massive U.S. Medicare program.

At the same time, the rise of direct-to-consumer (DTC) sales channels, retailer collaborations, and telemedicine platforms is collectively driving the "consumerization" wave in the weight loss drug market, significantly lowering the barriers to medication for patients and stimulating demand growth.

Driven by expectations of price reductions and the trend of consumerization, Goldman Sachs has raised its forecast for the global anti-obesity medication (AOM) market size in 2030 to approximately $102 billion.

"Price-for-Volume": Pricing Agreements Unlock Three Channels

According to Goldman Sachs' report, the GLP-1 drug pricing agreements reached by Eli Lilly and Novo Nordisk with the White House are central to reshaping the market. The agreements aim to expand patient accessibility in the U.S. Medicare, Medicaid, and direct-to-consumer (DTC) cash payment channels by lowering prices. In other words, this effectively incorporates these drugs into the Medicare coverage.

The report details the key aspects of the agreements, which will take effect starting in 2026:

• Medicare: Beginning April 1, 2026, a pilot program will include the obesity indications for Zepbound and Wegovy under Medicare Part D coverage, with a monthly fee priced at $245 and a patient out-of-pocket maximum of $50. In exchange, the prices for Mounjaro and Ozempic used for diabetes will also be reduced to $245/month (previously estimated by Goldman Sachs at $350). This removes a key growth limitation.

• Medicaid: The Medicaid price for Zepbound and Wegovy is also set at $245 per month, but the specific coverage is determined by each state. Currently, 13 states fully cover GLP-1 weight loss drugs.

• DTC/Cash Payment: Prices are also becoming more attractive. For example, Novo Nordisk's Wegovy is priced at $349 (excluding the starting dose); Eli Lilly's Zepbound multi-dose pen starts at $299, with subsequent doses up to $449; while the highly anticipated oral drug orforglipron starts at just $149, with subsequent doses up to $399.

The Rise of the "Consumerization" Wave: DTC and New Retail as New Battlegrounds

In addition to policy changes, the trend of "consumerization" in the weight loss drug market is becoming another powerful growth engine. Goldman Sachs' report points out that increased public awareness, reduced medication costs, the upcoming launch of oral drugs, and the rise of new distribution ecosystems such as direct-to-consumer (DTC), retail, and telemedicine are collectively lowering the barriers to medication for patients

• Lower Prices: Reduced the payment threshold for patients.
• Oral Medications Launch: Eli Lilly's orforglipron and Novo Nordisk's oral semaglutide are expected to launch in 2026, with their convenience and lower costs primarily targeting cash payments and DTC channels.
• Penetration in Markets Outside the U.S. (OUS): The OUS market is expected to be primarily out-of-pocket, with strong recent sales performance in India proving the huge potential of the cash payment market.
• New Distribution Ecosystem: The rise of DTC platforms (such as LillyDirect), retail collaborations (such as Eli Lilly with Walmart, Novo Nordisk with Costco), and telehealth platforms (such as Omada Health).

Data shows that this trend has begun to take shape. According to a recent Gallup survey, the proportion of American adults using GLP-1 medications for weight loss doubled from 5.8% to 12.4% over the past year.

The growth of DTC channels is particularly rapid. According to IQVIA data, as of the third quarter of 2025, sales of Zepbound vials through the Eli Lilly LillyDirect platform accounted for about 28% of its total prescription volume. Novo Nordisk's NovoCare platform also contributed significantly to cash payment sales. Goldman Sachs noted that since June 2025, nearly all of the growth in Zepbound prescriptions has come from cash payment channels, highlighting the strong momentum of the DTC model.

Additionally, collaborations between pharmaceutical companies and large retailers, as well as telehealth platforms beginning to offer GLP-1 prescription services, have further constructed a convenient, low-friction medication ecosystem. Goldman Sachs believes this model is similar to the development path of the Botox market, which bypassed traditional insurance systems and created a large out-of-pocket market through new delivery channels.

Demand Release: U.S. Medication User Forecast Upgraded

The decrease in prices directly translates to an increase in sales. Goldman Sachs has therefore upgraded its forecast for the number of users of anti-obesity medications (AOM) in the U.S.

The report predicts that by 2030, 64 million patients will be able to access AOM medications (previously forecasted at 50 million), with actual users reaching 15 million (previously forecasted at 12 million).

The additional 14 million accessible patients mainly come from:

• Medicare Channel: An increase of 8 million (from 10 million to 18 million)

• DTC/Cash Payment Channel: An increase of 2 million (from 10 million to 12 million)

• Medicaid Channel: An increase of 1 million (from 5 million to 6 million)

• Commercial Insurance Channel: An increase of 1 million (from 27 million to 28 million)

It is worth noting that while the DTC channel is the main driver of recent growth, its proportion in the total increment is relatively small as other reimbursement channels improve

Market Forecast Upgraded: Scale May Exceed $100 Billion by 2030

Goldman Sachs has updated its global anti-obesity drug model based on the latest market variables. In the baseline scenario, the report predicts that the total addressable market (TAM) for global anti-obesity drugs will reach $102 billion by 2030, up from the previous forecast of $95 billion.

The report also provides two sensitivity analysis scenarios:

• Optimistic Scenario: If the penetration rate of commercial channels increases (from 60% to 75%) and global sales increase by 10% compared to the baseline, the market size could reach $115 billion by 2030.

• Pessimistic Scenario: If there is greater price pressure and sales growth falls short of expectations, the market size would be $90 billion by 2030.

The core logic behind this forecast adjustment is that price declines will be offset by gradual sales growth, thereby driving overall market expansion.

Oral Drug Competition Heats Up, Eli Lilly Seizes Opportunity

Against the backdrop of "price for volume" and "consumerization," the upcoming oral weight loss drugs expected to launch in 2026 are highly anticipated, as they are seen as key to unlocking cash payments and DTC channels due to their convenience and lower costs.

Goldman Sachs has expressed optimistic expectations for Eli Lilly's oral drug orforglipron in the report. With the receipt of a priority review voucher from the U.S. Food and Drug Administration (FDA), its launch date is expected to be advanced from the third quarter of 2026 to the second quarter. As a result, Goldman Sachs has raised its 2026 sales forecast for orforglipron from $1.1 billion to $1.5 billion, and significantly increased its 2030 sales forecast for obesity indications alone from $14 billion to $19 billion.

Eli Lilly's management views orforglipron as a "generational opportunity," with its once-daily oral administration, no dietary restrictions, and potential cardiovascular and inflammatory benefits allowing it to target a much larger global market than existing products.

Based on the positive outlook for orforglipron and a reassessment of the market landscape, Goldman Sachs has raised Eli Lilly's 12-month price target from $951 to $1,145 and maintains a "Buy" rating.

For Novo Nordisk, the report keeps its sales forecast for obesity drugs for the fiscal years 2025-2028 largely unchanged. However, it notes that the company will benefit from Medicare market access and faster growth of oral Wegovy in DTC channels.

For Pfizer (PFE), following the acquisition of Metsera, Goldman Sachs has incorporated Metsera's injectable GLP-1 agonist MET-097i into its model. The report assumes that the drug will be launched in 2028, achieving $4 billion in global unadjusted peak sales by 2035.

The report concludes with a list of clinical catalysts to watch from the end of 2025 to 2026, which may further impact the market landscapeThis includes Eli Lilly's Retatrutide Phase III data, Pfizer's MET-097i monthly dosing data, and Novo Nordisk's head-to-head Tirzepatide Phase III data, among others. These will be key points for investors to assess the future competitive landscape.

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