Eli Lilly dominated the pharma landscape in 2025 powered by the exponential growth of the GLP-1 receptor agonist (RA) market to become the largest company in the industry by market cap, with the road ahead expected to be even more lucrative.

Clarivate Highlights Lilly’s Orforglipron and Retatrutide as Standout Cardiometabolic Assets

Lilly’s two late-stage cardiometabolic assets—orforglipron and retatrutide—were named among 11 standout pipeline drugs of the next decade in Clarivate’s new Drugs to Watch 2026 report.¹

The global obesity drug market is projected to reach $150 billion by 2035 as GLP-1s continue to evolve in terms of maturation and diversification, according to Clarivate.

“For 2026, pharma executives must recognize that metabolic innovation extends far beyond replicating existing GLP-1 therapies,” the report authors wrote. “The market demands differentiated approaches that address tolerability concerns, facilitate oral delivery, employ combination strategies to preserve lean body mass and provide evidence demonstrating real-world effectiveness that matches clinical trial outcomes.”¹

GLP-1 Market Expansion Drives Lilly’s Rise to Biopharma Market Cap Leader

Orforglipron is an investigational, once-daily small molecule, non-peptide, oral GLP-1 that does not carry restrictions on food and water intake and can be taken any time throughout the day.

Topline results released last month from the Phase III ATTAIN-MAINTAIN trial (NCT06584916) found that over 52 weeks, orforglipron achieved the primary endpoint in producing superior percent maintenance of weight loss vs. placebo among participants whose body weight reduction had plateaued following GLP-1 therapy.^2,3

Those who switched to orforglipron from Wegovy were able to maintain previously achieved weight loss, with an average difference of 0.9 kg. Participants switching from Zepbound to orforglipron were able to maintain prior weight loss with an average difference of 5.0 kg.

Retatrutide, a first-in-class, once-weekly triple hormone RA, has a mechanism of action that activates the body's GIP, GLP-1, and glucagon receptors. Results from the Phase III TRIUMPH-4 (NCT05869903) clinical trial released last month show retatrutide produced significant weight loss and improved pain and physical function among patients with obesity or overweight and knee osteoarthritis at 68 weeks.^4,5

“Orforglipron and retatrutide from Eli Lilly exemplify the next generation of metabolic therapies: oral formulations that promise improved adherence, triple-hormone mechanisms that deliver superior weight loss and expanded therapeutic applications spanning from brain health to renal disease,” Clarivate researchers noted. “The industry must now address critical challenges, including pricing negotiations, payer coverage limitations, supply constraints and the preservation of muscle mass during weight loss, with solutions emerging through novel mechanisms targeting amylin, cannabinoid receptors and activin pathways.”¹

Sales Projections Far Outpace Other Drugs on Clarivate’s 2026 Watch List

An FDA decision on orforglipron is expected by March 2026, with Clarivate projecting retatrutide will be ready for launch in 2028. The report projects that sales of orforglipron will reach $16 billion in 2031, whereas retatrutide will produce revenue of $30 billion that year, which includes $10 billion in obesity drug sales and $20 billion in diabetes drug sales.

The overall cardiometabolic medicine market is projected to reach $150 billion by 2035, according to Morgan Stanley estimates.⁶

“In the U.S., GLP-1 RA prescriptions for adults with overweight or obesity increased 586.7% from 2019 to 2024 (Fair Health, 2025),” the report authors wrote. “As GLP-1 RAs ripple into adjacent sectors, from brain health to renal disease, competition is heating up, and the appetite for next-generation therapies is growing. The GLP-1 pipeline is evolving rapidly, with assets spanning dual and triple hormone RAs. Oral delivery and reduced dosing frequency are emerging differentiators that aim to improve adherence and therefore real-world outcomes.”¹

Broader Drugs to Watch in 2026 Pipeline Span Oncology, Immunology, and Rare Disease

Among the 11 drugs cited in the Clarivate report, no other medications were projected to exceed more than $2 billion in 2031.

Johnson & Johnson landed two drugs on the watch list—the bladder cancer medication Inlexzo which was approved by the FDA in September 2025, and icotrokinra, a first-in-class investigational oral peptide that selectively blocks the IL-23 receptor and is expected to launch this year. Sales of these drugs are projected to achieve $1.8 billion and $1.5 billion, respectively, by 2031.

Rounding out the list are:

• GSK’s Exdensur (depemokimab) for asthma, with $510 million in sales projected in 2031.
• Otsuka Pharmaceutical’s immunoglobulin A nephropathy therapy Voyxact (sibeprenlimab), with $955 million in sales projected in 2031.
• Sanofi’s multiple sclerosis therapy tolebrutinib, with 1.4 billion in sales projected in 2031.
• BeOne Medicines’ BGB-16673, a novel treatment for chronic lymphocytic leukemia/small lymphocytic leukemia, with $1.2 billion in sales projected in 2031.
• BMS’ mezigdomide for multiple myeloma, with $1.5 billion in sales projected in 2031.
• Celcuity’s breast cancer treatment gedatolisib, with $1.1 billion in sales projected in 2031.
• Corcept Therapeutics’ relacorilant for ovarian cancer and Cushing syndrome, with $150 million in sales projected in 2031.

Regulatory and Pricing Uncertainty Looms Over Global Launch Potential

However, the report authors noted that ongoing challenges overseas as well as issues surrounding current FDA practices and drug pricing reform efforts could influence whether these therapies reach their full revenue potential.

“The 2026 landscape is complicated by unprecedented regulatory uncertainty, particularly in the United States,” the authors wrote. “A Trump-appointed FDA, evolving pricing pressures from the Inflation Reduction Act (IRA) and shifting health technology assessment (HTA) requirements across global markets create strategic complexity. Executives must balance accelerated development timelines with rigorous evidence generation, anticipate diverse regulatory requirements across regions and build flexibility into global launch strategies.”¹

References

1. Clarivate. Drugs to Watch 2026. Online. 2026. Accessed January 8, 2026. https://clarivate.com/drugs-to-watch/

2. Lilly's orforglipron helped people maintain weight loss after switching from injectable incretins to oral GLP-1 therapy in first-of-its-kind Phase 3 trial. Eli Lilly. News release. Published December 18, 2025. Accessed January 8, 2026. https://www.prnewswire.com/news-releases/lillys-orforglipron-helped-people-maintain-weight-loss-after-switching-from-injectable-incretins-to-oral-glp-1-therapy-in-first-of-its-kind-phase-3-trial-302645471.html

3. A Study of Orforglipron for the Maintenance of Body Weight Reduction in Participants Who Have Obesity or Overweight With Weight-Related Comorbidities (ATTAIN-MAINTAIN). ClinicalTrials.gov. Updated December 22, 2025. Accessed January 8, 2026. https://clinicaltrials.gov/study/NCT06584916

4. Lilly's triple agonist, retatrutide, delivered weight loss of up to an average of 71.2 lbs along with substantial relief from osteoarthritis pain in first successful Phase 3 trial. Eli Lilly. News release. Published December 11, 2025. Accessed January 8, 2026. https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-delivered-weight-loss-of-up-to-an-average-of-71-2-lbs-along-with-substantial-relief-from-osteoarthritis-pain-in-first-successful-phase-3-trial-302638804.html

5. A Study of Orforglipron (LY3502970) in Adult Participants With Obesity or Overweight With Weight-Related Comorbidities (ATTAIN-1). ClinicalTrials.gov. Updated November 5, 2025. Accessed January 8, 2026. https://clinicaltrials.gov/study/NCT05869903

6. The Exponential Growth of Obesity Drugs. Morgan Stanley. Online. Published May 9, 2025. Accessed January 8, 2026. https://www.morganstanley.com/insights/articles/weight-loss-medication-market-unstoppable-growth