The competition in the GLP-1 track is becoming increasingly fierce, and the game between giants to grab the market is becoming more and more obvious.

On May 11th, Eli Lilly and Company released research data on SURMUNT-5, which exploded like a bombshell in the global weight loss drug market. Its new GLP-1/GIP dual receptor agonist, Tilpotide, outperformed Novo Nordisk's semaglutide in key indicators such as weight loss of 20.2% vs 13.7% and waist circumference reduction of 18.4cm vs 13.0cm.

According to the data disclosed by Eli Lilly, in the primary endpoint of the study, telapride achieved a relative weight loss of 1.47 times compared to semaglutide. According to research data based on treatment plan estimation goals, at week 72, the average weight loss rate achieved by telmisartan was 20.2%, while that of semaglutide was 13.7%. The average weight loss of the Tilpotide group was 22.8kg, and the average weight loss of the Smeaglutide group was 15.0kg.

In addition, among the key secondary endpoints of the study, teriparatide outperformed semaglutide in all weight loss goals. The proportion of participants who achieved a weight loss of ≥ 15% in the Terpotide group was 64.6%, while in the Smeaglutide group it was 40.1%. In addition, the average waist circumference decreased by 18.4cm in the tilpotide group, while it decreased by 13.0cm in the semaglutide group.

A pharmaceutical industry analyst from a securities firm told 21st Century Business Herald reporters that this head to head trial, known as the "GLP-1 century war" in the industry, is believed to not only rewrite the guidelines for obesity treatment, but also foreshadow the restructuring of the global market structure worth billions.

In the next two years, the GLP-1 market will present a '2+N' pattern - Lilly and Novo Nordisk will jointly occupy more than 80% of the market share, while other manufacturers compete for the remaining cake. ”The above securities industry analysts predict.

Two giants seize the market

According to the 2025 World Obesity Map, it is estimated that by 2030, over 2.9 billion adults worldwide will be in a state of high body mass index (BMI ≥ 25kg/m2). According to statistics from 2018, more than half of Chinese adults are overweight/obese, and it is expected that by 2030, this proportion will exceed 65.3%. The medical expenses related to overweight/obesity in China will reach 418 billion yuan, accounting for 21.5% of the total national medical expenses.

The three main methods for treating obesity include lifestyle and behavioral interventions, anti obesity drug therapy, and metabolic surgery. Among them, lifestyle and behavioral interventions are the cornerstone of long-term weight management. With the progress of drug development, the application of weight loss drugs has become an important treatment in the field of long-term weight management.

Thanks to their star product GLP-1 drug, Lilly and Novo Nordisk have demonstrated strong performance growth.

According to the first quarter performance report released by Eli Lilly on May 1st, the company's revenue for the first quarter was $12.729 billion, a year-on-year increase of 45%; Net profit was 2.759 billion US dollars, a year-on-year increase of 23%. From a regional perspective, Lilly's revenue for the first quarter in the United States was $8.489 billion, a year-on-year increase of 49%; Europe reached 2.389 billion US dollars, a year-on-year increase of 66%; China's revenue was 451 million US dollars, a year-on-year increase of 20%. It is worth noting that Eli Lilly contributed a total of $6.15 billion in revenue to Eli Lilly with two major indications, accounting for approximately 48% of the revenue in the first quarter of 2025.

According to Novo Nordisk's first quarter 2025 results, the total revenue was 78.087 billion Danish kroner (approximately 11.216 billion US dollars), a year-on-year increase of 18%; R&D investment was 10.308 billion Danish kroner (approximately 1.481 billion US dollars), a year-on-year increase of 19%. In terms of regional distribution, in the first quarter of 2025, the US market revenue reached 44.316 billion Danish kroner (approximately 6.365 billion US dollars), a year-on-year increase of 17%, while the Chinese market revenue reached 5.622 billion Danish kroner (approximately 807 million US dollars), achieving a year-on-year increase of 22%.

In the first quarter, Novo Nordisk's total revenue from semaglutide was 56.934 billion Danish kroner (approximately 8.011 billion US dollars), a year-on-year increase of 31%, which was higher than Eli Lilly's Tilpotide (6.15 billion US dollars).

The aforementioned analyst pointed out that in terms of the current global GLP-1 drug market size, semaglutide, tilpotide, and dulaglutide occupy the top three positions. By 2025, it is expected that the global market size will exceed 60 billion US dollars. Novo Nordisk, with its first mover advantage, and Eli Lilly, with its weight loss effect (average weight loss of 20% vs semaglutide 14%), are both accelerating their efforts to seize market share.

According to industry statistics, the overall sales scale of GLP-1 peptide drugs approved for market worldwide is expected to reach 51.8 billion US dollars in 2024, a year-on-year increase of 42%. It is expected that the global market size will increase to around 60 billion US dollars by 2025, and by 2030, the market size may further grow to 80 billion US dollars or even higher.

The three major dimensions of competition are becoming increasingly intense

In the past two years, on the GLP-1 track, Eli Lilly and Novo Nordisk have been secretly competing in terms of drug safety, efficacy, and indications expansion.

To compete in the global market, conducting "head to head" trials is the best way for domestic innovative drugs to verify that it is a better product. The so-called "head to head" research refers to clinical trials conducted under the same experimental conditions, using clinically used therapeutic drugs or methods as direct controls, and can be regarded as a "direct one-on-one" between two drugs.

According to the "head to head" study disclosed by Lilly this time, SURBOUNT-5 (NCT05822830) is a multicenter, randomized, open label phase 3b trial to evaluate the efficacy and safety of tirzepatide and semaglutide in obese or overweight adults (without diabetes) with at least one complication (such as hypertension, dyslipidemia, obstructive sleep apnea, cardiovascular disease). Participants in both treatment groups received counseling on dietary control and increased exercise.

The research results showed that the trial enrolled approximately 751 patients from the United States and Puerto Rico, and randomly divided them in a 1:1 ratio. Patients were treated with the maximum tolerated dose of tilboptide (10mg or 15mg) or semaglutide (1.7mg or 2.4mg), respectively. 89.3% of participants in the treatment group received at least one dose of 15mg; In the treatment group with semaglutide, 92.8% of participants received at least one dose of 2.4mg. The main objective of this study is to demonstrate the superiority of tilpotide over semaglutide in reducing the percentage of body weight from baseline at week 72.

The aforementioned analyst believes that the successful "head to head" clinical trial of Eli Lilly has validated the enormous potential of multi-target synergy. Currently, 67% of GLP-1 drugs entering Phase III clinical trials worldwide have dual targets. Not only that, the two giants are expanding the battlefield from simple weight loss to full chain management of metabolic syndrome

For example, the research and development of Smeglutide has expanded from diabetes and obesity to cardiovascular disease, chronic kidney disease, NASH and other fields, and consolidated its market position through oral preparations and capacity expansion; Telopotide has significant therapeutic effects in improving MASH and liver fibrosis. Lilly has disclosed that the Phase III data is expected to be released in 2026; In addition, in terms of the association with Alzheimer's disease, the protective role of GLP-1 receptors in the central nervous system has become a new hot topic of research for various pharmaceutical companies.

Faced with technological barriers from multinational pharmaceutical companies, the Chinese GLP-1 Corps is adopting a strategy of "differentiation breakthrough+industry chain integration" to accelerate its layout. For example, Huadong Pharmaceutical compresses unit costs to 40% of imported drugs through self-produced raw materials; Shiyao Group is laying out an mRNA LNP delivery system and plans to achieve a 60% reduction in GLP-1 drug costs within three years; Micro core biological development of "GLP-1+metformin" compound preparation, targeting pre diabetes population; Junshi Biotechnology explores the combination of GLP-1 drugs with traditional Chinese medicine, and explores new mechanisms of metabolic regulation.

In this technological revolution that reshapes human metabolic health, Chinese pharmaceutical companies are facing both the challenge of technological divide and the opportunity to overtake on the bend. The key to winning the future market lies in achieving the most cost-effective solution while ensuring security. With the GLP-1 race changing from a "blue ocean" to a "red ocean", Eli Lilly and Novo Nordisk have already advanced to the finals. For local pharmaceutical companies, only continuous innovation can overcome the cycle and write their own "golden age".