Recently, Eli Lilly became the world's first pharmaceutical company to surpass a trillion-dollar market capitalization. This milestone not only signifies recognition from the capital market but also symbolizes the pharmaceutical industry entering a new era of value.

For a long time, the pharmaceutical industry has struggled to produce true "super giants" due to the fragmented nature of disease ranges and the limited market size. However, the emergence of GLP-1 drugs has completely changed this landscape. From diabetes to weight loss, and then to the treatment of diseases that benefit multiple organs, GLP-1 is redefining the boundaries of "blockbuster drugs."

01 GLP-1 Revolution

Looking back at the development of GLP-1, it was initially just an ordinary player in the field of diabetes treatment. Insulin has always held a dominant position in the diabetes market, and GLP-1 drugs, as a latecomer, initially had a relatively limited market size. The diabetes market is worth approximately $50 billion, with insulin long accounting for half of it. Due to strong channel dependence and high customer loyalty in the existing market, other multinational pharmaceutical companies showed little interest in entering this market. At that time, GLP-1 was like a quietly working behind-the-scenes guardian, possessing strength but not receiving enough attention.

What truly turned GLP-1's fate around was a bold innovation by Novo Nordisk. Novo Nordisk astutely recognized GLP-1's enormous potential in the weight loss field and successfully expanded its reach into this area. The weight loss market has a large patient population with good tolerance for side effects and a strong willingness to pay, instantly creating a massive incremental market. GLP-1, originally confined to diabetes treatment, transformed into a "star" in the weight loss industry, attracting numerous multinational corporations (MNCs) to enter the market, resulting in explosive market growth.

If Novo Nordisk was the pioneer of the GLP-1 revolution, then Eli Lilly was the one who deepened it. Through a series of forward-looking strategic initiatives, Eli Lilly propelled GLP-1 to a new level as an "all-around drug."

In its target strategy, Eli Lilly takes an unconventional approach, actively exploring the mysteries of multi-target synergistic effects. Telpoeptide can simultaneously activate two targets, GLP-1R and GIPR, demonstrating remarkable advantages in multiple dimensions, including blood sugar control, weight loss, and cardiovascular benefits.

To improve patient convenience and adherence to medication, Eli Lilly has invested heavily in research and development of long-acting technologies. Through ingenious design and optimization of drug molecular structures, it has successfully developed a series of long-acting GLP-1 formulations, such as dulaglutide.

Eli Lilly is also actively expanding the indications for GLP-1, extending its application to more disease areas. From chronic kidney disease (CKD) to Alzheimer's disease, from metabolic dysfunction-associated fatty liver disease (MASLD) to tobacco and alcohol addiction, GLP-1 is becoming one of the most imaginative treatment platforms in modern medicine. In the CKD field, GLP-1 drugs can improve kidney function, reduce proteinuria levels, and slow disease progression through multiple mechanisms. In Alzheimer's disease research, preliminary evidence shows that GLP-1 may exert neuroprotective effects through mechanisms such as regulating neuroinflammation and enhancing synaptic plasticity. For MASLD patients, GLP-1 drugs can effectively reduce liver fat content, improve liver function, and safeguard liver health. In the treatment of tobacco and alcohol addiction, GLP-1 has also shown potential application value, and is expected to help patients overcome addiction and regain a healthy life.

02 Why did Li Lai become king?

Novo Nordisk's first-mover advantage should not be underestimated. It was the first company to discover the weight-reduction function of GLP-1, opening the door to a vast market for GLP-1. However, in the fierce market competition, Eli Lilly, with its own strength and unique strategies, successfully overtook Novo Nordisk, staging a remarkable comeback.

Eli Lilly is building a more complete and diverse product pipeline. Unlike Novo Nordisk's single-target semaglutide, telperdine can simultaneously activate both GLP-1R and GIPR targets, resulting in more potent blood glucose-lowering, weight-loss, and cardiovascular protective effects. Clinical studies have shown that telperdine outperforms semaglutide in reducing glycated hemoglobin, reducing weight, and improving cardiovascular risk factors. In a clinical trial for patients with type 2 diabetes, the telperdine treatment group showed a greater reduction in glycated hemoglobin and more significant weight loss than the semaglutide group. In addition to telperdine, Eli Lilly is actively developing next-generation products such as GLP-1/GIP/GCG tri-target agonists, continuously enriching and improving its product pipeline.

Eli Lilly demonstrates remarkable flexibility and openness in its external collaborations, which provides a powerful impetus for its research and innovation. Lilly has established extensive partnerships with numerous research institutions, universities, and biotechnology companies, achieving rapid exchange and integration of technology and knowledge through resource sharing and complementary strengths. This open collaborative model enables Lilly to promptly access the latest research results and technological breakthroughs, accelerating product development and increasing the success rate of its research. Lilly also actively engages in licensing collaborations, licensing its research results to other companies to maximize the commercial value of its technologies and further expand its market share.

In its R&D strategy, Eli Lilly has demonstrated exceptional foresight and systematic approach. It closely tracks cutting-edge technologies and research hotspots in the industry, proactively identifying emerging targets and therapeutic areas, laying a solid foundation for future development. In the GLP-1 field, Eli Lilly not only focuses on traditional indications such as blood sugar control and weight loss, but also actively explores its application potential in multiple areas including cardiovascular disease, neurodegenerative diseases, and liver diseases. For cardiovascular disease, Eli Lilly has conducted numerous clinical trials to study the impact of GLP-1 drugs on the risk of cardiovascular events, providing new ideas and methods for the treatment of cardiovascular diseases. In the area of neurodegenerative diseases, Eli Lilly has also invested significant resources in exploring the therapeutic effects of GLP-1 in diseases such as Alzheimer's and Parkinson's, potentially bringing new hope to these intractable diseases.

In contrast, some of Novo Nordisk's R&D strategy decisions have gradually put it at a disadvantage in the competition. While Novo Nordisk's adherence to the Amylin route has some theoretical innovation, its efficacy in actual clinical studies has not met expectations. The underperformance of the GLP-1 + Amylin combination strategy has put Novo Nordisk at a disadvantage in its competition with Eli Lilly, forcing it to accelerate its R&D pace to catch up. In the oral GLP-1 field, Novo Nordisk's choice of SNAC technology, while enabling oral administration of peptides, faces problems such as low oral bioavailability, high API dosage, and high cost. With limited production capacity, these issues have severely hampered the commercialization of the product, preventing it from fully realizing its commercial value.

03 Opportunities for Chinese Pharmaceutical Companies

In recent years, Chinese pharmaceutical companies have made a remarkable transformation from license-in to license-out in the GLP-1 field. This transformation is not only a powerful testament to the improved R&D capabilities of Chinese pharmaceutical companies, but also an important symbol of China's pharmaceutical industry moving to the center of the global stage.

Taking Innovent Biologics' Masdopeptide as an example, this is an independently developed GLP-1R/GCGR dual agonist with remarkable efficacy in lowering blood sugar and reducing weight. In early 2025, the GLORY-1 study showed that after 48 weeks of treatment, 610 overweight Chinese patients at the 6mg dose group achieved an average weight loss of 14.37%, exceeding the 9.9% achieved by semaglutide after 44 weeks and approaching the efficacy of metabolic surgery; in patients with fatty liver, liver fat content decreased sharply by 80.2%, far exceeding traditional GLP-1 drugs. Based on this excellent clinical data, Innovent Biologics entered into a global strategic collaboration with Takeda Pharmaceutical, with a transaction valued at up to $11.4 billion, bringing both financial returns and promoting Masdopeptide globally, showcasing the strength of China's innovative drug development.

Federal Pharmaceuticals is a typical example of a Chinese pharmaceutical company pursuing a "license-out" model. In March 2025, it licensed the global rights outside Greater China for its GLP-1/GIP/GCG triple receptor agonist UBT251 to Novo Nordisk in a deal valued at $2 billion. UBT251 is chemically synthesized and acts simultaneously on GLP-1, GIP, and GCG receptors, offering advantages in the treatment of various complex metabolic diseases. It has already received clinical approval in both China and the US for multiple indications, and has completed and met the criteria for a Phase Ib clinical trial in China for overweight/obesity. This collaboration demonstrates the global market value of UBT251 and showcases the international recognition of China's innovative drug development capabilities.

Chinese pharmaceutical companies have advantages in the GLP-1 field not only in the results of licensing overseas, but also in rapid clinical trials, cost control, and target combinations.

China's large patient population and abundant clinical resources provide convenience for pharmaceutical companies to conduct clinical trials. The clinical trial approval process has been optimized and accelerated. For example, Hengrui Medicine's GLP-1/GIP dual-target agonist HRS9531 injection has shown positive results in the Phase III clinical trial in China, and it plans to submit a marketing application to the Chinese drug regulatory authorities soon. Its US partner is advancing the global clinical registration process. This rapid clinical advancement capability helps Chinese pharmaceutical companies seize market opportunities.

Cost control is a strength of Chinese pharmaceutical companies. Their complete peptide synthesis industrial chain, mature production processes, and advantages in labor and raw material costs help reduce drug production costs. Gan & Lee Pharmaceuticals has accumulated significant strength, establishing a complete peptide drug production system. It has made breakthroughs in the modification of the GLP-1 molecular structure, developing the bi-weekly dosing drug bovangravitide. Leveraging its insulin production advantages, it has laid the foundation for improving the cost-effectiveness of its GLP-1 products.

Chinese pharmaceutical companies are keeping pace with international advancements in the GLP-1 field. In terms of target combinations, they are actively exploring multi-target synergistic innovative drugs. For example, Hengrui Medicine has developed the dual-target drug HRS9531 and the tri-target agonist HRS-4729, which respectively possess dual regulation of blood glucose and body weight and stronger lipid metabolism improvement capabilities, giving Chinese pharmaceutical companies a differentiated competitive advantage.

In the future, Chinese pharmaceutical companies have significant room for growth in the GLP-1 field. Progress has been made in the development of oral formulations. Hengrui's HRS9531 tablets have improved bioavailability, achieving weight loss effects equivalent to injectable formulations with reduced gastrointestinal side effects. Gan & Lee Pharmaceuticals' oral borfanglutide GZR18 tablets have also shown promising results. Oral GLP-1 formulations are expected to become new market favorites. Regarding new target combinations, the combination of GLP-1 with FGF21, SGLT-2, and other targets holds great promise and is expected to achieve breakthroughs. In terms of expanding indications, GLP-1 has potential therapeutic value in cardiovascular, neurodegenerative, and liver diseases, and Chinese pharmaceutical companies can increase R&D investment to expand the market.

04 Conclusion

Eli Lilly's breakthrough of a trillion-dollar market capitalization is not only a victory for the company itself, but also a concentrated manifestation of the revolutionary value of the GLP-1 target. It tells us that the ceiling of the pharmaceutical industry is not fixed, but is constantly being broken as scientific understanding, clinical needs, and technological pathways evolve.

In the future, GLP-1 will continue to expand in the fields of weight loss, metabolism, neurology, and cardiovascular diseases. If Chinese companies can seize this opportunity of technological iteration and global cooperation, they may very well create their own "Lilly Moment" in the next decade.

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