It's been an exciting, if sometimes uncertain, year for the business of GLP-1s.

Just have a look at the past week. On Wednesday, Novo Nordisk (NVO) missed second quarter Wall Street estimates for its GLP-1 sales, reflecting ongoing supply constraints of weight-loss drug Wegovy. The stock slipped 7% on the news.

But on Thursday, Eli Lilly (LLY) blew past Wall Street estimates for its GLP-1 sales. It beat Wall Street quarterly sales projections by 13% — with total sales of $4.3 billion for weight-loss drug Zepbound and diabetes drug Mounjaro. The stock surged more than 10% on Thursday as a result of Lilly signaling the easing of supply constraints helped Novo too. Its stock rose 5% that day.

In the background, there are other competing candidates inching towards their market debuts. Tema ETFs founder and CEO Maurits Pot told Yahoo Finance that the market will soon, for instance, include multiple players.

"We think actually over time this is going to be a four-to-six-horse race because right now you only have one device which is injectable going after one treatment, which is weight loss. But we're seeing innovation in parts of the market where we're looking at people looking at oral instead of injectable. People are looking at applications beyond weight loss," Pot said.

Which is why some say market moves based on quarterly results in the near term isn't a good strategy.

"Lilly is a reminder that it's silly to look at either of these names on a 90-day basis when the market is north of $100 billion," Jared Holz, healthcare sector expert at Mizuho, told Yahoo Finance.

But it's exactly that large market potential that is keeping investors on edge.

"At the end of the day, it is still the most meaningful market in dollars in all of pharma and biotech," he said.

That all said, here's where some of the industry players stand after reporting second quarter earnings:

Novo Nordisk: Despite the miss in Wegovy sales, Denmark-based Novo remains the market leader with its share of the GLP-1 market. CEO Lars Jørgensen said the company has 69% of the market share globally, and diabetes drug Ozempic specifically leads with a 46% share. The company also got approval for Wegovy for patients at risk of heart disease. But it could cede its lead after delaying an FDA filing to treat heart failure with GLP-1s until early next year. Competitor Lilly reiterated its guidance to file this year.

Eli Lilly: Lilly's weight-loss drug Zepbound completed its second full quarter on the market and has zoomed into blockbuster territory at a greater clip than any of the other three new GLP-1s on the market — all while faced with supply constraints and lack of coverage by large employers and the federal government. It has now filed with the FDA to get approval for Zepbound to treat sleep apnea, which could change the coverage hurdle. Meanwhile, Lilly's drugs came off the FDA shortage list, and it launched in a handful of new global markets. The company is also focused on getting its oral version, orforglipron, to market to help increase access and broaden options for patients.

Pfizer: Pfizer (PFE) is no longer seen as a near-term threat after it faced a setback with its oral GLP-1 candidate, danuglipron. The company had to nix its twice-daily pill and opt to test once-daily doses, which are still in mid-stage trials. The company could still get a piece of the pie, though, as demand will continue to outstrip supply.

Roche: The Swiss-based company (RHHBY) bet nearly $3 billion on a biotech, Carmot Therapeutics, and acquired a few GLP-1 candidates as a result. The investment is already providing a return. Both an injectable and an oral candidate in early-stage trials are showing promise with comparable weight loss to the current market leaders. That gives the Big Pharma company a chance to invest in and advance candidates more efficiently than if they were still under the biotech brand. The deal closed at the start of this year.

Amgen: One of the most promising and differentiated candidates advancing through trials is Amgen's (AMGN) MariTide. It could be used less frequently (once monthly) than the current once-weekly GLP-1 injectables. It also has a similar weight-loss profile to the current market leaders. It's already in phase II clinical trials but poised to enter the final stage, phase III, sometime in the near future. CFO Peter Griffith told Yahoo Finance the company is gearing up for more studies on obesity-related diseases as well. So far this year, the company has increased its research and development budget by 30%.

Viking: Viking Therapeutics (VKTX), the Swiss-based biotech, has had quite a year. Its stock so far in 2024 is up more than 200%, thanks to promising results for its oral pill. Viking, as a result, could also be an acquisition target, according to Mizuho's Holz. That's because it is now competing with big players, which can invest in drug trials at a much quicker pace. Even if Viking were to be acquired at a 100% premium, it would still be a deal for an acquirer, Holz said. Consider that the daily moves in the market for both Lilly and Novo are multiples higher than the total market value of Viking, he said.

Hims & Hers: The telehealth and mail order delivery platform (HIMS) is a different kind of player in the weight-loss craze. While it is not a maker of the injectables, it is planning to buy a compounding pharmacy in order to continue its offerings of GLP-1s — which is allowed by the FDA for drugs on the shortage list. The company only recently decided to start offering the drugs after only being in the support business for patients. In the second quarter, the company reported $16 million in revenue from GLP-1 sales. But once the shortage of branded GLP-1s ends, the future is uncertain. CFO Yemi Okupe told Yahoo Finance that the company was already seeing an increase in business prior to adding the GLP-1s. But adding them has given Hims a boost. Hims remains one to watch because it and other similar platforms offer these services for cash rather than through insurance, which signals the level of demand for the products as insurers continue to avoid coverage.

Anjalee Khemlani is the senior health reporter at Yahoo Finance, covering all things pharma, insurance, care services, digital health, PBMs, and health policy and politics. Follow Anjalee on all social media platforms @AnjKhem.

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