GLP-1 prescriptions hit a record high, Medicare Bridge begins to provide a lift, and Lilly gains modest share

Overview

This report is Bernstein's weekly data tracking of the U.S. GLP-1 market, focusing on TRx, NRx, NBRx, market share, formulations, and reimbursement changes for the week ended July 24, 2026. The core conclusion is that Medicare Bridge/BRIDGE-BALANCE-related reimbursement is beginning to provide a visible lift to prescriptions, GLP-1 new-patient starts remain elevated, and Lilly is benefiting more clearly from obesity-indication treatment starts.

Core views

The report believes GLP-1 demand remains strong, with total prescriptions and new-patient starts both at elevated levels. Prescriptions for Zepbound's non-vial formulations are growing broadly, with increases in KwikPen and auto-injector prescriptions offsetting declines in vial prescriptions. Foundayo prescriptions continue to improve, but its launch ramp remains uncertain. Novo's Wegovy Pill continues to grow, while Wegovy pen and Ozempic shares have softened modestly. Overall, Lilly's TRx share continues to edge higher, and expanded Medicare obesity coverage could become a more important growth driver in the second half.

Analysis framework

The report primarily uses weekly IQVIA prescription data to track total prescriptions, branded new prescriptions, new-treatment starts, refill contributions, and four-week rolling year-over-year and week-over-week trends, with market share broken down by company, product, formulation, and dose. The research also incorporates Medicare reimbursement start dates, expanded commercial insurance coverage, weeks since product launch, and management commentary on IQVIA capture rates to assess the underlying demand and revenue trajectory of products including Foundayo, Zepbound, and Wegovy Pill.

Methodology notes

• Prescription data trackingIQVIA prescription metrics

  TRx, NRx, NBRx, CBRx

  TRx represents total prescriptions, equal to new prescriptions plus refills, and can also be decomposed into branded new prescriptions plus continuation prescriptions. NBRx counts only patients who have not used the brand in the past 12 months and is an important measure of brand acquisition and the quality of new-patient starts.

• Market share analysisWeekly share and four-week rolling trends

  Company- and product-level TRx share, NBRx share, and four-week rolling year-over-year growth

  The report identifies trends through changes in prescription share for the current week, past four weeks, and past twelve weeks, avoiding overinterpretation of single-week fluctuations while using year-over-year growth to measure demand momentum.

Asset mapping & comparison

Structured mapping from thesis to named assets (strengths, weaknesses, peers, risks).

• Eli Lilly & Co (LLY)

  Core beneficiary

  Strengths

  Strong Zepbound growth, sustained high Mounjaro share, improving Foundayo prescriptions, and Medicare Bridge beginning to drive new obesity-treatment starts.

  Weaknesses

  Foundayo's launch trajectory is slower than expected and requires more time for physician education and patient activation.

  Comparison

  Relative to Novo, Lilly continues to gain modestly in TRx share and is benefiting from new-treatment starts.

  Risks

  Uncertainty remains around Foundayo's underlying demand, IQVIA capture rates, pricing changes, and the pace at which reimbursement coverage is realized.

• Novo Nordisk A/S

  Primary competitor

  Strengths

  Wegovy Pill continues to grow and could be understated due to potentially low IQVIA capture rates.

  Weaknesses

  Wegovy pen prescriptions and share are declining, while Ozempic share has also decreased modestly.

  Comparison

  Novo's overall TRx share is below Lilly's and has recently shifted modestly toward Lilly.

  Risks

  Actual capture rates for oral products, adherence, commercial coverage, and the intensity of Lilly's competition will affect future share.

• GLP-1 drug market

  Industry theme

  Strengths

  Total prescriptions, NBRx, and new-patient starts all remain elevated, indicating continued strong demand.

  Weaknesses

  Single-week data may be affected by holidays, channel reporting, and fluctuations in capture rates.

  Comparison

  Tirzepatide-related products continue to outperform semaglutide-related products.

  Risks

  Payer coverage, price declines, real-world adherence, and product launch timing could all alter the growth curve.

Key data

• Total weekly GLP-1 TRx2.71MUp 0.94% week over week, or approximately 25k prescriptions.
• Total GLP-1 NBRx298kUp 6.5% week over week, reaching a record high.
• Four-week rolling year-over-year growth34.3%Above 33.3% in the prior week.
• Lilly / Novo TRx share61.3% / 38.7%Continued to shift modestly toward Lilly from 61.0% / 39.0% the prior week.
• Zepbound market share27.9%Up from 27.7% the prior week, with absolute prescriptions increasing by approximately 13k.
• Mounjaro market share32.2%Prescriptions increased by approximately 8k week over week, while share was broadly stable.
• Foundayo TRx29,387In its 16th week since launch, up 2,626 prescriptions, or 9.8%, week over week.
• Wegovy Pill TRx172kIn its 29th week since launch, up approximately 2.0k, or 1.2%, week over week, with approximately 6.6% share.
• Wegovy pen performanceDown approximately 3k week over weekShare declined from 12.7% to 12.5%, while four-week rolling year-over-year growth fell from 27.2% to 22.2%.
• Foundayo revenue estimateQ2E approximately $126m; FY26E approximately $1.3BThe report estimates these figures based on blended pricing and an IQVIA channel breakdown, while emphasizing that early actual prescription data remain limited.

Impact & implications

For investors, the data reinforce Lilly's relative advantage in the GLP-1 market, particularly the improvement in new-treatment-start share driven by Zepbound and expanded Medicare-related access. If Foundayo accelerates following greater patient education, DTC advertising, and expanded reimbursement, it could provide additional upside; however, if its launch ramp remains slower than expected, FY26 revenue expectations could come under pressure. For Novo, Wegovy Pill continues to provide an entry point for new patients, but weakening Wegovy pen and Ozempic shares indicate that competitive pressure persists.

Risks

• Foundayo remains in the early stage of its launch, with limited actual prescription data; activation from the BRIDGE/BALANCE programs and DTC advertising could create significant uncertainty.
• IQVIA capture rates may differ across channels and products, and management commentary from both Novo and Lilly indicates that some prescriptions may not be fully captured.
• Expanded Medicare and commercial insurance coverage may be accompanied by lower prices, meaning revenue growth may not track prescription growth.
• Competition and switching among Wegovy Pill, Zepbound, and Foundayo could alter company share trends.
• Overseas launches remain at an early stage, and key markets such as the United Kingdom may not show a revenue inflection until subsequent quarters.

What to watch

• The continued impact of Medicare Bridge and the BRIDGE/BALANCE programs on TRx, NBRx, and new-treatment starts in the second half.
• Foundayo's TRx, NBRx, refill share, and FY26E revenue trajectory from week 17 onward.
• Changes in the prescription mix among Zepbound KwikPen, auto-injector, and vial formulations.
• The actual IQVIA capture rate for Wegovy Pill and the divergence between patient counts and TRx.
• Relative changes between Lilly and Novo in TRx share, NBRx share, and new-treatment starts.
• The trade-off between pricing and prescription volume following expanded commercial PBM coverage.