NEWS.

Eli Lilly's Mounjaro booked $8.66B in Q1 2026 sales, ahead of Merck's Keytruda at $7.9B, making tirzepatide the world's top-selling pharmaceutical and ending Keytruda's two-year run at #1 (a position the anti-PD-1 antibody had held since displacing Humira in early 2023). The full tirzepatide platform (Mounjaro plus Zepbound) generated $36.5B in 2025 against Keytruda's $31.6B. It is the first time a peptide therapeutic has taken the #1 drug spot since the historical era of insulin biosimilars.

Rhythm Pharmaceuticals reported Q1 2026 results May 5 that pulled in opposite directions: Imcivree (setmelanotide) net revenue of $60.1M (+59% YoY) on the acquired hypothalamic obesity launch and EU authorization, while the EMANATE Phase 3 program in genetically caused MC4R-pathway diseases missed its primary endpoint in all four independent substudies. The MC4R agonist class works in the indications it is approved for and does not generalize to heterozygous-variant populations the way the program had hoped.

Crinetics Pharmaceuticals reported Q1 2026 with Palsonify (paltusotine) at $10.3 million net product revenue, nearly double the $5.4M Q4 2025 launch quarter. 263 unique prescribers (up from 125), 232 new patient enrollment forms, and ~70% of patients reimbursed. Cash $1.3B, R&D up 17.6% to $100.1M to fund Phase 3 paltusotine in carcinoid syndrome and atumelnant in CAH and Cushing's syndrome.

Novo Nordisk CEO Mike Doustdar told CNBC May 6 that the Wegovy franchise (injectable, pill, Ozempic, Rybelsus) writes 65% of new US GLP-1 prescriptions, calling the moment a 'turnaround situation.' The Q1 disclosure also confirmed termination of the single-chamber CagriSema co-formulation; the dual-chamber injectable continues with FDA decision expected late 2026. Jefferies pushed back, arguing the lower end of guidance was not lifted enough.

Novo Nordisk Q1 2026 reported Wegovy pill sales of DKK 2.26 billion (~$354M), almost double the DKK 1.16 billion consensus, on 1.3 million Q1 prescriptions and 2 million cumulative since the January 5 launch. Total net sales DKK 96.82B (+24% YoY), operating profit DKK 59.62B (+54%), guidance tightened from -5/-13% to -4/-12%. The volume-versus-price question gets a clean answer: volume won.

Reuters reported May 5 that Novo Nordisk's Wegovy pill booked roughly 721,000 US prescriptions in Q1 per IQVIA, with about 450,000 of those scripts on the 1.5 mg starter dose at $149/month. Novo's Q1 print on May 6 will test whether volume offsets the falling-price headwind that has cut more than $400 billion from the company's market value since 2024.

IQVIA's most recent weekly tracker put Novo Nordisk's Wegovy pill at roughly 113,354 US prescriptions versus Eli Lilly's Foundayo at 5,612. The 20-to-1 ratio reflects four months of Wegovy pill ramp, three weeks of Foundayo ramp, and a structural commercial advantage Novo is likely to widen rather than narrow.

Amgen's Q1 2026 update advanced MariTide on three fronts: MARITIME-1 Phase 3 obesity is enrolling, MARITIME-2 EXTENSION launched for weight-loss maintenance, and three Phase 3 type 2 diabetes studies are slated to start in 2026. The peptide-antibody-conjugate architecture supports monthly-or-less dosing, and the GLP-1 agonist plus GIP antagonist mechanism is structurally different from the dual-agonist standard.

Novo Nordisk's Ozempic pill (oral semaglutide) hits 70,000+ U.S. pharmacies May 4, the first FDA-approved oral peptide GLP-1 cleared for cardiovascular risk reduction, at $25 per three-month supply for insured T2D patients. Lilly's Foundayo, the small-molecule oral GLP-1 launched three weeks earlier, hit 5,612 prescriptions in its third week. The oral GLP-1 category finally has two products in active launch.

Eli Lilly reported Q1 2026 revenue of $19.8 billion, up 56% year over year, with Mounjaro at $8.66 billion (+125%) and Zepbound at $4.16 billion (+80%). 65% volume growth offset 13% price decline. Full-year 2026 revenue guidance raised $2 billion at each end of the range to $82-85 billion.

Zealand Pharma and Roche announced April 29 that they are formally advancing petrelintide into Phase 3 trials for chronic weight management in H2 2026, on the strength of ZUPREME-1's 10.7% weight loss with placebo-like tolerability. The Phase 3 design includes both a monotherapy arm and a combination arm with Roche's GLP-1/GIP dual agonist enicepatide.

OrbiMed-incubated Pinnacle Medicines closed an oversubscribed $89 million Series B for oral peptide therapeutics designed to match injectable-biologic efficacy in asthma, COPD, immunology, and inflammation. The round signals that the peptide capital flow is finally widening beyond GLP-1.

A C&EN feature surveys three amylin obesity candidates (Novo cagrilintide, Lilly eloralintide, Roche/Zealand petrelintide). Phase 2 has not delivered the muscle-preservation or GI-tolerance profile early investors expected. CagriSema's Phase 3 head-to-head against tirzepatide is the readout that decides the case.

Eli Lilly reports Q1 on April 30 with Foundayo's slow first two weeks (3,707 scripts vs Wegovy pill's 18,410 at the same week) under scrutiny. Novo follows May 6 with guided 5-to-13% sales decline. Goldman models Lilly's oral GLP-1 at 60% of the daily-oral segment by 2030 versus Novo at 21%.

A new retail floor and a new capital ceiling for the weight-loss drug market, landed in the same week. The price patients pay and the price investors pay, both just reset.