Novo Nordisk vs Eli Lilly — the GLP-1 market landscape in 2026

Dr.AddMedPHL said:

Relative and absolute effects need reading together.

This is where I part company with the consensus forming above. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

anders_CPH said:

I keep finding that the number in the press summary and the number in the paper are not the same number, and the difference is always in the same…

anders_CPH said:

...regarding the trial evidence...

I think this is an underappreciated point. To expand on it with some data:

A recent meta-analysis of 22 RCTs (n=18,900) found that the trial evidence was associated with a consistent effect size across diverse patient populations[1].

The NNT was 20, which is comparable to statins for secondary prevention. That's a strong clinical argument for this approach.

InsuranceTom said:

I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them.

Propensity score matching studies and the trial evidence: when RCTs aren't available for a specific question, propensity score-matched observational studies can provide useful evidence.

A recent PSM study of 25,000 GLP-1 users vs matched controls showed reduced MI incidence (HR 0.78) over 5 years of follow-up[1].

These results complement the RCT data and suggest the benefits translate to real-world populations.

One thing that is still open after MounjBrad’s answer:

What would you measure differently if you were starting again?

OP back with an update, since a thread like this is useless without one.

Follow-up: I read the paper rather than the summary and the qualifier I was missing was in the second paragraph of the results.