A snow removal machine is seen working while a Boeing 737 American Airlines passenger aircraft is parked at gate on the tarmac of LaGuardia airport in New York on January 25, 2026.

Charly Triballeau | Afp | Getty Images

American Airlines‘ promised turnaround is off to a rocky start this year.

Pilot and flight attendant unions have called CEO Robert Isom’s leadership into question as the airline’s performance has trailed its rivals by a wide margin, a trend that has translated to lower profit-sharing for American’s more than 130,000 employees. Adding to employee frustration, the airline struggled to recover from major winter storms in recent weeks and crews were left stranded — some without a place to sleep beside the airport.

Late Friday, the pilots’ union wrote to the airline’s board, seeking a meeting to discuss the carrier’s financial and operational challenges.

“Our airline is on an underperforming path and has failed to define an identity or a strategy to correct course,” the board of directors of the Allied Pilots Association wrote. The union called for “leaders who are willing, equipped, and empowered to get the house in order.”

Isom replied on Saturday that as board member and chief executive it is “most appropriate” to meet as soon as possible.

“The Board and I are aligned with you in the desire to make American the strongest airline possible in every respect,” he wrote.

American made $111 million last year, an amount eclipsed by profits from Delta Air Lines and United Airlines, which brought in $5 billion and more than $3.3 billion, respectively, even though American flew similar capacity in 2025.

“I know that it is a meager profit-sharing, a very small profit-sharing pool this year. Again, when you break even, that’s the kind of profit-sharing you have,” Isom told employees after releasing earnings results on Jan. 27, according to a recording of the event that was reviewed by CNBC. “I’m disappointed in that.”

‘2026 can’t just feel different’

American is trying to catch up to rivals with premium products that bring in higher fares, a bright spot in the industry as coach cabin revenue growth has been elusive. It has also worked to reverse the damage from a failed direct-to-traveler business-travel strategy, whose architect American ousted in May 2024.

2026 is crucial for the carrier.

The Fort Worth, Texas-based airline issued an upbeat outlook for the year on Jan. 27, and Isom told crews that he was optimistic about improvement this year. He also noted that many staff, like flight attendants, make more than their counterparts at United, where cabin crews and other employees are in contract negotiations.

Isom is leading what he has pitched as a major transformation of American. The strategy includes improving customer service, the network and revenue management.

This week, he took his message to about 6,000 leaders at a conference the airline held at Globe Life Field in Arlington, Texas.

“We’ve had conversations as a senior leadership team about how we can’t pass up any opportunity … how we need to hold ourselves accountable,” Isom said at the event, according to a transcript which was seen by CNBC. “It starts with us at the top, but it’s all of us here today and how you lead your teams. 2026 can’t just feel different. It has to be different.”

American issued its 2026 outlook as it was juggling the aftermath of a late January winter storm that walloped much of the U.S. with snow, ice and sleet and preparing for another storm that ended up hitting its major hub of Charlotte, North Carolina, while competitors dug out faster.

The financial results, coupled with the slow storm recovery, drew anger from both pilot and flight attendant union leaders, which together represent about 40,000 crew members.

This week, two American Airlines flight operations leaders met with the union to discuss recent problems, and the union told members, “Our pilots will not accept platitudes, empty words, and the absence of decisive action any longer.” 

Association of Professional Flight Attendants President Julie Hedrick said on Jan. 27 that Isom, who became CEO in 2022, “is missing the human factor” and that “many of us have been here for a very long time, and we don’t see an ending that puts us in a better place.”

Isom acknowledged the trouble American’s crew members faced during the late January storm that paralyzed a large swath of the United States and called the weather “probably the most impactful” during his decades-long tenure at the airline.

Robert Isom, chief executive officer of American Airlines Group Inc., speaks during a Bloomberg Television interview in New York, US, on Wednesday, Dec. 10, 2025.

Christian Monterrosa | Bloomberg | Getty Images

Tale of two Texas airlines

American had an especially difficult 2025, which started with the collision of an Army Black Hawk helicopter into one of the carrier’s regional jets that was arriving at Washington, D.C.’s Ronald Reagan Washington National Airport, killing all 67 people on both flights. The airline and its rivals were also hit by the U.S. government shutdown late last year.

“We’re off to a fast start based on the booking trends we’ve observed in January, all-time records for the first three weeks of the year,” Isom told analysts on the Jan. 27 earnings call.

But investors also want to the airline to prove its progress.

American’s stock is roughly flat this year. Its competitor, 20 miles away in Dallas, Southwest Airlines, is also trying to remake itself, and its stock is up more than 30% in 2026. Shares of United and Delta are up more than 3% and more than 8%, respectively, for the year.

Southwest’s forecast that it could quadruple earnings this year has had investors in a bullish frenzy. That carrier recently sealed the biggest transformation in its nearly 55 years of flying (to some travelers’ chagrin): assigning seats for the first time, adding its first-ever bag fees, and rolling out basic economy tickets and other changes. Investors’ confidence boosted Southwest’s stock to a nearly four-year high last month after it reported results.

Read more about American Airlines’ turnaround plans

All U.S. carriers are investing heavily in higher-end travel over standard coach, and even Southwest is considering opening its first airport lounge, its CEO told CNBC last year.

American is likewise revamping its wide-body planes with larger, single business-class cabins, putting in a three-class cabin on new Airbus narrow-bodies and expanding its airport lounges. The airline has also refreshed its food and beverage options, including offering Lavazza coffee and Champagne Bollinger. For its 100th anniversary this spring, it’s also adding caviar and beef Wellington for long-haul premium cabins.

Isom has said he expects half of American’s revenue to come from “premium offerings” toward the end of the decade.

Fight over Chicago

Several planes wait in line to taxi down a runway after a winter snow storm affected the area at O’Hare International airport on Nov. 30, 2025 in Chicago, Illinois.

Jim Vondruska | Getty Images

One major battle for American is at Chicago O’Hare International Airport, where United CEO Scott Kirby, whom American fired in 2016, has vowed to keep his old employer at bay.

Both carriers are ramping up their schedules there next summer. Deutsche Bank estimated in a note Monday that United generates about $10 billion in revenue at O’Hare and that American generates more than $5 billion.

Around the time American reported earnings, United posted a digital billboard in Chicago that read “More on time, less canceled flights. Aadvantage, United,” using the same spelling as American’s AAdvantage loyalty program. Bankrupt Spirit Airlines is also seeking to transfer two gates at Chicago O’Hare to United for $30 million, which would give United more ground at the airport.

But from Chicago to Charlotte, questions still remain for American.

“It’s unclear if the current strategy will close the margin gap to its peers,” Melius Research airline analyst Conor Cunningham said about American. “It will take a lot of time to execute. You can’t just turn premium revenue on.”

Cunningham added, “It took Delta over a decade to cultivate a premium image,” pointing to the U.S. profit leaders’ transformation.

Read more CNBC airline news

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Chinese tech company Baidu announced Monday it can sell some robotaxi rides without any human staff in the vehicles.

Baidu

BEIJING — Chinese robotaxi companies are expanding abroad at a faster clip than U.S. rivals Waymo and Tesla — at a time when industry leaders say autonomous driving is finally near an inflection point.

“I think robotaxi has reached a tipping point, both here in China and in the U.S.,” Baidu CEO Robin Li said Tuesday on an earnings call, according to a FactSet transcript.

“There are enough people who have [had the] chance to experience driverless rides, and the word of mouth has created positive social media feedback,” he said, noting that the wider public exposure could speed up regulatory approval.

His comments echoed similar notes of optimism in the last few weeks from Nvidia CEO Jensen Huang and Xpeng Co-President Brian Gu — who reversed his previously cautious stance after faster-than-anticipated tech advances. Xpeng is launching robotaxis in the southern Chinese city of Guangzhou next year.

It’s a global market with significant growth potential, likely worth more than $25 billion by 2030, according to Goldman Sachs’ estimates in May.

To seize that opportunity, Chinese companies are aggressively expanding overseas and claim they are close to making robotaxis a viable business, rather than simply burning cash to grab market share.

In the last 18 months, Baidu, Pony.ai and WeRide landed partnerships with Uber that allow users of the ride-hailing app to order a robotaxi in specific locations, starting in the Middle East.

Such tie-ups “will be critical to success” as they enable robotaxi companies to operate more efficiently and reach profitability more quickly, said Counterpoint Senior Analyst Murtuza Ali.

Once we can generate profit for every single car in a second-tier city [like Wuhan] in mainland China, we can generate profits in lots of cities across the world.

Halton Niu

General manager for Apollo Go’s overseas business

Expanding on experience at home

Baidu says that since late last year, its Apollo Go robotaxi unit has reached per-vehicle profitability in Wuhan, where the company has operated over 1,000 vehicles in its largest deployment in China.

That means ridership is enough to offset a Wuhan taxi fare that’s 30% cheaper than in Beijing or Shanghai, and far below prices in the U.S. or Europe. Besides developing autonomous driving systems, Baidu has also produced electrically-powered robotaxi vehicles — without relying on a third-party manufacturer — that are 50% cheaper.

“Once we can generate profit for every single car in a second-tier city [like Wuhan] in mainland China, we can generate profits in lots of cities across the world,” Halton Niu, general manager for Apollo Go’s overseas business, told CNBC.

“Scale matters,” he said. “If you only deploy, for example, 100 to 200 cars in a single city, if you only cover a small area of the city, you can never become profitable.”

How U.S. rivals stack up

Scale remains the dividing line. In the U.S., Alphabet-owned Waymo operates more than 2,500 vehicles and is expanding rapidly from major cities in California to Texas and Florida, with plans to enter London next year, following its first overseas venture in Tokyo.

Tesla sells its electric cars in China, and reportedly showed off its Cybercab in Shanghai this month. But it began testing its robotaxis in Texas only in June, and this week obtained a permit to operate in Arizona.

Amazon’s Zoox is also ramping up its expansion in the U.S., but has not released overseas plans.

The three companies have not disclosed plans to break even on their robotaxis.

Baidu Apollo Go’s Niu did not rule out an expansion into the U.S. But for now, the robotaxi operator plans to enter Europe with trials in parts of Switzerland next month, following their expansion in the Middle East this year.

Abu Dhabi last week gave Apollo Go a permit to charge fares to the public for fully driverless robotaxi rides, which are operated locally under the AutoGo brand, eight months after local trials began in parts of the city.

But Chinese startup WeRide said it received a similar permit on Oct. 31 to charge fares for its fully driverless robotaxi rides in Abu Dhabi, and claimed that removing human staff from the cars would allow it to make a profit on each vehicle.

That puts Pony.ai furthest from profitability among the three major Chinese robotaxi operators. Its CFO Leo Haojun Wang told The Wall Street Journal in mid-September that the company aimed to make a profit on each car by the end of this year or early next year.

Pony.ai plans to launch a fully autonomous commercial robotaxi business in Dubai in 2026, after receiving a testing permit in late September. The company plans to roll out in Europe in the coming months and has also outlined an expansion into Singapore.

Pony.ai and WeRide are set to release quarterly earnings early next week.

“Currently, companies like Waymo, Baidu, WeRide and Pony.ai are leading in terms of fleet size, which positions them advantageously in the race for profitability,” said Yuqian Ding, head of China Autos Research at HSBC.

Scale and safety

Fleet size is becoming a competitive marker. Pony.ai reportedly said it plans to release 1,000 robotaxis in the Middle East by 2028, while WeRide aims to operate a fleet of 1,000 robotaxis in the region by the end of next year.

Niu said Apollo Go operates around 100 robotaxis in Abu Dhabi and Dubai, and plans to double its vehicle fleet in the next few months.

“Apollo Go has had a head start with significantly more test rides than the other two,” Kai Wang, Asia equity market strategist at Morningstar, said in an email. “The more testing and data you can collect from trips taken, the more likely the AI sensors are able to recognize the objects on the road, which means better safety as well.”

He cautioned that despite some initial progress, the robotaxi race remains uncertain as “no one has truly had mass adoption for their vehicles.”

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Coverage remains limited. Even in China, robotaxis are only allowed to operate in selected zones, though Pony.ai recently became the first to win regulatory approval to operate its robotaxis across all of Shenzhen, dubbed China’s Silicon Valley. In Beijing, self-driving taxis are mostly limited to a suburb called Yizhuang.

Anecdotally, CNBC tests have found Pony.ai offered a smoother ride than Apollo Go, which was prone to hard braking.

As for safety — which is critical for regulatory approval — none of the six operators has reported fatalities or major injuries caused by the robotaxis so far. But Apollo Go and Waymo have begun advertising low airbag deployment rates.

Even if that’s not enough to convince regulators worldwide, Beijing is expected to ramp up support at home.

HSBC’s Ding predicts the number of robotaxis on China’s roads could multiply from a few thousand to tens of thousands between the end of this year and 2026, a shift that would give operators more proof that their model works.

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A combination image shows an injection pen of Zepbound, Eli Lilly’s weight loss drug, and boxes of Wegovy, made by Novo Nordisk.

Hollie Adams | Reuters

The appetite for blockbuster weight loss and diabetes drugs is far from satisfied. 

From fresh competition to new uses, the market is quickly vaulting into a new stage of growth. But factors including insurance coverage, pricing, copycat drugs and the development of new pills will ultimately determine how far the treatments will reach.

Eli Lilly and Novo Nordisk are still the dominant players, as demand for their weekly injections shows few signs of slowing. Eli Lilly has pulled ahead in the market, saying during its third-quarter earnings call on Thursday that it gained share for the fifth consecutive quarter and that its drugs account for nearly 6 out of 10 prescriptions within the injectable obesity and diabetes class.

But both firms are focused on ramping up supply, testing new uses for their medicines and bringing the next wave of obesity drugs to patients, including more convenient pills. 

Behind them is a slate of drugmakers – from biotech upstarts to pharma giants – racing to win a slice of what some analysts expect could be a roughly $100 billion market by the end of the decade. There may be plenty of room for new entrants: McKinsey projects that 25 million to 50 million U.S. patients could use GLP-1s by 2030. 

Nearly every major pharmaceutical company has bet on obesity drugs, often through deals with smaller developers, including businesses based in China. While some experimental drugs are further along than others, all are likely years away from hitting the market, and their competitive potential will depend on future data showing their effectiveness and how well patients tolerate them.

As competition heats up, many patients are still struggling to access the drugs. Some insurers, including Medicare, don’t cover GLP-1s for obesity, which can cost roughly $1,000 per month before rebates.

Eli Lilly and Novo Nordisk have rolled out discount programs for cash-paying patients to close the gap, and more employers are offering coverage as GLP-1s prove their added health benefits like treating obstructive sleep apnea and chronic kidney disease as well as slashing cardiovascular risks.

Still, some patients continue to use cheaper, copycat versions of branded treatments – even though those alternatives are restricted in many cases. While Novo Nordisk and Eli Lilly’s drugs are no longer in shortage, both companies are cracking down on pharmacies, medspas and other suppliers that mass-produce and market cheaper compounded GLP-1s.

While new competitors and lower-cost pills could allow drugs to reach more patients, access will largely depend on how companies like Novo Nordisk and Eli Lilly choose to price their drugs in the years ahead.

Here’s what to know about the state of the booming weight loss drug market. 

Novo Nordisk scrambles to catch up to Lilly

David Ricks, chief executive officer of Eli Lilly & Co., during a news conference at Generation Park in Houston, Texas, US, on Tuesday, Sept. 23, 2025.

Mark Felix | Bloomberg | Getty Images

Eli Lilly has taken the lead in the injectable GLP-1 market. Once the frontrunner, Novo Nordisk lost ground, particularly in the U.S., after supply chain issues, Eli Lilly’s emergence and the spread of compounded options.

Eli Lilly eclipsed its Danish rival for the first time in May, when it secured 53% of the market during the first quarter. In August, Eli Lilly said its share rose to 57% during the second quarter.  

TD Cowen analyst Michael Nedelcovych said that’s largely because Eli Lilly’s injections are superior to Novo Nordisk’s drugs in terms of safety and efficacy. Eli Lilly’s diabetes drug Mounjaro is viewed as a better treatment than Novo Nordisk’s Ozempic, he noted. Real-world data and a head-to-head clinical trial have shown that Eli Lilly’s obesity injection Zepbound leads to more weight loss than Novo Nordisk’s Wegovy.

“It’s better efficacy, and at least anecdotally in real-world practices, it’s better tolerability,” Nedelcovych said. “In our business, that’s usually all that’s required for share gains, and I think we’re seeing that play out very quickly.” 

Investors have unloaded Novo Nordisk’s stock, which has fallen almost 40% this year. Novo Nordisk cut its profit and sales forecast in July, saying compounded drugs had cut into Wegovy’s market. The company had already lowered its 2025 outlook in May.

As competition mounts, data on Novo Nordisk’s experimental medicines also underwhelmed Wall Street and raised concerns about the growth of its drug portfolio beyond Wegovy and Ozempic. 

In a note in September, BMO Capital Markets analyst Evan Seigerman said the company raised expectations too high for its next-generation obesity drug CagriSema, was slow to launch direct-to-consumer sales of its popular drugs and had a “tepid initial response” to compounders selling copycat treatments. 

What’s more, Medicare is negotiating the price of Novo Nordisk’s semaglutide – the active ingredient in Ozempic, Wegovy and the company’s diabetes pill Rybelsus – effective in 2027, which could further cut into revenue. Eli Lilly’s tirzepatide, the active ingredient in Mounjaro and Zepbound, likely won’t be subject to price discussions until the end of the decade. 

Novo Nordisk is betting its new CEO, Mike Doustdar, will help it regain its footing. He took the helm in late July after the board ousted former top executive Lars Fruergaard Jorgensen. 

Doustdar isn’t wasting any time to make changes: Novo Nordisk in September announced plans to cut around 9,000 roles, or roughly 11.5% of its global workforce.

There is still turbulence at the pharmaceutical giant. On Tuesday, Novo Nordisk said several board members will step down after clashing with the controlling shareholder, the Novo Nordisk Foundation, on the makeup of the board.

The compounding issue 

Novo Nordisk still faces another major challenge: the persistence of cheaper, compounded versions of semaglutide. 

The company for now “is definitely much more vulnerable” to competition from copycats than Eli Lilly is, largely because most of them contain or claim to be semaglutide, said Cowen’s Nedelcovych. He added that Novo Nordisk is “already on its back foot” in the market, so it can’t afford to lose more share.

Patients flocked to compounded GLP-1s when branded injections were in short supply over the last two years, or not covered by their insurance.

Compounding is a practice where pharmacies mix ingredients of a drug to create a specialized version tailored to a patient’s specific needs, such as those with allergies to certain ingredients. When a branded drug is in short supply, pharmacies are allowed to make larger quantities of compounded versions to help fill the gap.

A view shows a Novo Nordisk sign outside its office in Bagsvaerd, on the outskirts of Copenhagen, Denmark, on July 14, 2025.

Tom Little | Reuters

But Novo Nordisk and Eli Lilly have both invested billions to increase manufacturing capacity for their injections, which has already started to pay off. 

The FDA declared an end to the shortages of tirzepatide and semaglutide over the last year. Those decisions legally barred compounding pharmacies from making and selling copycats of those drugs by deadlines that passed earlier this year, except in rare cases where it’s medically necessary. 

Novo Nordisk in June said some mass, so-called 503B compounding pharmacies have scaled back production, but accused others — including those tied to Hims & Hers — of continuing to sell the drugs under the “false guise” of personalization. In August, Novo Nordisk executives noted that around 1 million U.S. patients are taking compounded GLP-1s.

The issue also plagues Eli Lilly. While the FDA regulates 503B pharmacies, most 503A sites fall under state oversight. Nedelcovych likened shutting them down to “a case of whack-a-mole.” Eli Lilly and Novo Nordisk’s lawsuits against telehealth companies, pharmacies and others since 2023 have consumed time and resources, with mixed legal outcomes.

The FDA also doesn’t appear to be taking an aggressive stance on compounded GLP-1s: The agency in September published a “green list” of imported GLP-1 drug ingredients deemed safe to let into the country. 

Insurance coverage is still spotty

Limited insurance coverage for GLP-1s is blocking out patients who can’t afford their roughly $1,000 monthly price tags. That access gap has become a political and corporate flashpoint, with pressure mounting on employers and the government to expand coverage.

Many health plans, including Medicare, cover GLP-1s for the treatment of diabetes but not obesity. Medicaid coverage of obesity drugs is sparse and varies by state, according to health policy research organization KFF. 

Coverage for GLP-1s for obesity has ticked up slightly: A May survey of more than 300 companies by the International Foundation of Employee Benefit Plans, or IFEBP, found that 36% provided coverage for GLP-1s for both weight loss and diabetes, up from 34% in 2024. 

Still, many employers and health plans remain hesitant due to high costs. In 2025, weight-loss GLP-1s accounted for an average of 10.5% of total annual claims among employers, up from 8.9% in 2024 and 6.9% in 2023, IFEBP found.

“If employers weren’t already on board before, they’re still waiting,” said Julie Stich, vice president of content at IFEBP. “The cost issue is still a major, major issue for them.”

Some plans are concerned that patients won’t stay on the drugs long term due to gastrointestinal side effects, such as nausea and vomiting, and could regain the weight they lost, said John Crable, senior vice president of Corporate Synergies, a national insurance and employee benefits brokerage and consultancy. Employers, which can experience high turnover, are also hesitant to cover costly drugs for workers who may leave the company within a few years, Crable added.

Crable added that new direct-to-consumer programs from Eli Lilly and Novo Nordisk — which let patients pay cash for treatments at less than half their monthly list price — may also discourage employer coverage.

Stitch said employers also have questions about how oral obesity drugs, which could be available as soon as 2025, could affect demand and costs.

But she said coverage could still grow, especially as GLP-1s gain new approvals for more chronic conditions. Wegovy is cleared for reducing cardiovascular risk and fatty liver disease, while Zepbound is approved for sleep apnea.

Novo Nordisk is also testing semaglutide in Alzheimer’s, with initial late-stage trial results expected this year. If that study shows that GLP-1s reduce the risk of cognitive decline, “it would give a big boost” to Novo Nordisk and Eli Lilly because it could encourage patients to stay on them longer, said Leerink Partners analyst David Risinger.

“You’re paying for the GLP-1 drug with the hope that obesity or these other conditions will improve, so that health-care costs for these individual employees will get better as you move forward,” Stich said.

Some plans have also introduced cost controls, like BMI thresholds, to manage spending.

Stich added that broader Medicare coverage could eventually drive private insurers to follow suit. The Trump administration plans to pilot coverage of weight loss drugs under Medicare and Medicaid, which could expand access to millions of older Americans, the Washington Post reported in August.

All eyes are on pills

Malerapaso | Istock | Getty Images

While Novo Nordisk already sells an oral GLP-1 for diabetes, the company and Eli Lilly could soon bring pills specifically for weight loss to patients.

Some experts and analysts believe they could fundamentally shift the market, helping more patients access treatment and alleviating the supply shortfalls of existing injections. But others raise questions about how much of a role pills will play in the space given that some appear to be less effective than injections and bring greater side effects.

Novo Nordisk’s 25-milligram oral semaglutide could win approval for obesity by the end of the year, which would make it the first needle-free alternative for weight loss on the market. The daily pill appears to be slightly more effective than a competing oral GLP-1 from Eli Lilly called orforglipron, based on data from separate phase three trials. 

Still, Eli Lilly’s pill could have a few notable advantages. Both drugs work by mimicking the GLP-1 gut hormone to suppress appetite and regulate blood sugar. But while Novo Nordisk’s pill is a peptide medication, orforglipron is a small-molecule drug.

That means Eli Lilly’s treatment is absorbed more easily in the body and doesn’t require dietary restrictions like Novo Nordisk’s does. Some analysts say orforglipron will also be easier to manufacture at scale than Novo Nordisk’s, which is crucial as demand for obesity and diabetes injections outpaces supply. In August, Eli Lilly CEO David Ricks told CNBC the company hopes to launch its pill globally “this time next year.” 

In an August note, Goldman Sachs analysts forecast daily oral pills will capture 24% share — or around $22 billion — of the 2030 global weight loss drug market, which they expect to be worth $95 billion. 

The Goldman analysts said they expect Eli Lilly’s pill to have a 60% share — or roughly $13.6 billion — of the market for daily oral treatments in 2030. They expect Novo Nordisk’s oral semaglutide to have a 21% share — or around $4 billion — of that segment. The remaining 19% slice will go to other emerging pills, the analysts said.

TD Cowen’s Nedelcovych said he has been “treading kind of cautiously” in his outlook for oral weight loss drugs. He said that’s in part because physician consultants and other experts believe injections, which are more effective and easier to tolerate than pills, will dominate the market for the foreseeable future. 

Nedelcovych said the convenience of a once-daily pill may not be enough to convince patients to switch, since some of them “really don’t mind” taking an injection once a week. Nedelcovych added that tapering off injections and switching to pills as a maintenance regimen “also doesn’t seem to make a ton of sense, when we ask physicians about it.” 

He said if pills are less effective at promoting weight loss, it raises concerns that patients who initially lose significant weight on an injection could gain some back after switching to an oral drug.  A phase three study from Eli Lilly, which is studying orforglipron’s ability to maintain weight loss, will bring more clarity on that issue. 

Companies have said that pills could reach patients who don’t take injections because they are afraid of needles. But Nedelcovych said the “fate of oral weight loss therapies could really revolve” around another category of people: patients who could benefit from weight loss treatments but don’t take injections because they believe they are meant for those with serious diseases.

“They’re really just invisible to the marketplace right now,” he said. “But they could have different views about an oral therapy, which could be considered more like a vitamin so they would be more amenable to taking that.” 

The question top of mind for health experts is how companies will price the pills. 

“If it wasn’t for the fact that they can be made more cheaply, I wouldn’t care” about pills, said Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital.

The direct-to-consumer platforms from Eli Lilly and Novo Nordisk offer Zepbound and Wegovy for roughly $500 a month. She said less effective pills with more side effects will have to be priced lower than that if companies want health-care providers to prescribe them first over injections. 

Competition is creeping up 

It’s still unclear who will be the next viable player to enter the weight loss drug space. Many experimental drugs from other companies may not reach patients until the end of the decade. 

Still, some drugmakers have made strides over the last year and a half, inking deals with obesity biotechs or releasing promising data on experimental treatments. Several companies are trying to drive innovation with new drugs that promote weight loss differently, are taken less frequently or preserve muscle mass, among other changes. 

Some investors are eager to see a drug that promotes even more weight loss than Wegovy and Zepbound, which has hit those companies’ stocks when their treatments don’t meet lofty expectations in clinical trials. But some health experts say many patients don’t need to lose more than 20% of their weight. 

“I am not even looking for greater weight loss anymore. What is wrong with 16% and 22% weight loss? Nothing, right?” said Apovian, referring to the levels of weight loss seen with some existing and experimental drugs. 

Apovian said she is looking for treatments that target new gut hormones, which could address patients who may not lose weight on GLP-1s. She pointed to drugs targeting amylin analogs – an emerging form of weight loss treatment that mimics a hormone co-secreted with insulin in the pancreas to suppress appetite and reduce food intake.

Several drugmakers, including Novo Nordisk and Eli Lilly, are betting on amylin analogs as part of the next wave of obesity treatments

Other experts have said that an ideal competitor would promote weight loss while being easier to tolerate than existing injections. That’s because many people discontinue those injections – and may not experience the full health benefits – due to gastrointestinal side effects such as nausea and vomiting. 

Without late-stage trial data on any of the new competitors, it’s too early to say who will be able to address that issue.

The Amgen logo is displayed outside Amgen headquarters on May 17, 2023 in Thousand Oaks, California.

Mario Tama | Getty Images

Some drugs are much closer to answering that question than others. 

For example, Amgen in March said it has started two critical late-stage trials for its experimental weight loss injection MariTide, which is designed to be taken monthly or even less frequently and promotes weight loss differently from competitors. 

In a mid-stage study, patients with obesity taking MariTide lost up to 16.2% of their weight in one year when analyzing all participants regardless of discontinuations, or up to 19.9% when only analyzing those who stayed on the treatment. But patients experienced a high rate of side effects and discontinuations in the trial. 

Those results support the company’s decision to use a slower dosing schedule over eight weeks to make the drug more tolerable in phase three studies. 

Some pharmaceutical companies have turned to China for their obesity bets. For example, Merck in December snagged the rights to an early-stage experimental GLP-1 pill from Chinese drugmaker Hansoh Pharma, in a deal worth up to $2 billion. 

That acquisition and other smaller players raised questions about the fate of public U.S.-based obesity biotechs such as Viking Therapeutics, which were once seen as hot takeover targets. Some analysts argue that their experimental drugs, most of which are still in mid-stage development, have not differentiated themselves enough from existing treatments. 

“Unless and until these molecules show that they truly are differentiated in phase three, I don’t think there’s really a reason for given pharma to lay out a large transaction to gain access to it,” said TD Cowen’s Nedelcovych. 

He said the “clearest path forward” for U.S.-based obesity biotechs is likely inking partnerships with larger firms to develop and commercialize their drugs.

But Nedelcovych noted that “there really aren’t too many large pharmas who aren’t already spoken for at this point.”

The post What’s next for the weight loss drug market: pills, rivals, insurance appeared first on Our Story Insight.

Tesla launched a revamped version of its Model Y in China.

Tesla

Tesla on Friday announced a revamped version of its popular Model Y in China, as the U.S. electric car giant looks to fend off challenges from domestic rivals.

The Model Y will start at 263,500 Chinese yuan ($35,935), with deliveries set to begin in March. That is 5.4% more expensive than the starting price of the previous Model Y.

A spokesperson for Tesla China said that the new Model Y is only open for pre-sale in the Chinese market, rather than being launched globally.

Tesla’s Model Y refresh comes after the auto giant this month reported its first ever annual decline in overall deliveries for 2024.

Elon Musk’s electric vehicle firm is facing heightened competition around the world, from startups and traditional carmakers in Europe. In China, the company continues to face an onslaught of rivals from BYD to newer players like Xpeng and Nio.

Jason Low, principal analyst at Canalys, notes that the Tesla Model Y was the best-selling EV in China in 2024 and that the popularity of the car “remains high.” However, he noted that the competition in the sports utility vehicle (SUV) segment with vehicles priced between 250,000 yuan and 350,000 yuan “has been fierce.”

“Tesla must showcase compelling smart features, particularly a unique but well localized cockpit and services ecosystem,” as well as “effective” semi-autonomous driver assistance features “to ensure its competitiveness in the market,” Low added.

Tesla is offering a number of incentives for customers to buy the Model Y including a five-year 0% interest financing plan.

The new Model Y can accelerate from 0 kilometers per hour to 100 kilometers per hour in 4.3 seconds, Tesla said, exceeding the speed capabilities of the previous vehicle. The Model Y Long Range has a further driving range on a single charge versus its predecessor.

Tesla has not introduced a new model since it began delivering the Cybertruck in late 2023, which starts at nearly $80,000.

Investors have been yearning for a new mass-market model to reinvigorate sales. Tesla has previously hinted that that a new affordable model could be launched in the first half of 2025.

Despite Tesla’s headwinds, the company’s stock is up nearly 70% over the last 12 months, partly due to CEO Musk’s close relationship with U.S. President-elect Donald Trump.

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