Novo Nordisk’s bid to best a previous offer from Pfizer to acquire the bio/pharma company, Metsera, is the latest in the competitive obesity drug market. What are the assets the companies are vying for, and how do they stack up against other contenders in the obesity drug market?

By Patricia Van Arnum, Editorial Director, DCAT, pvanarnum@dcat.org

Novo Nordisk versus Pfizer for Metsera
Novo Nordisk is making a play to boost its position in the obesity drug market through an unsolicited proposal to acquire Metsera, a New York-based clinical-stage bio/pharmaceutical company focused on obesity and cardiometabolic diseases, a company that Pfizer had sought to acquire last month (September 2025), placing Metsera in a bidding war between the two companies.

Novo Nordisk’s proposal values Metsera at up to $77.75 per share, for a total of approximately $9 billion compared to a total deal value of a merger with Pfizer of $7.3 billion ($4.9 billion upfront plus a contingent value right for potential additional milestone payments of up to approximately $2.4 billion). Under Novo Nordisk’s proposal (announced on October 30, 2025), Novo Nordisk would acquire all outstanding shares of Metsera’s common stock at a price of $56.50 per share in cash, equal to an approximate aggregated equity value of $6.5 billion or approximate enterprise value of $6.0 billion and contingent value rights (CVRs) for up to $21.25 per share in cash or an approximate aggregated value of up to $2.5 billion based on the achievement of certain clinical and regulatory milestones. The cash consideration will be paid at signing in exchange for non-voting preferred stock representing 50% of Metsera’s share capital and the CVRs will be issued upon the closing of the acquisition in exchange for the remaining shares.

Pfizer had agreed to acquire Metsera last month (September 2025), in deal worth up to $7.3 billion ($4.9 billion upfront plus a CVR for potential additional milestone payments of up to approximately $2.4 billion). The Boards of Directors of both Metsera and Pfizer had unanimously approved the transaction, which was at the time of the acquisition announcement, was expected to close in the fourth quarter of 2025, subject to the satisfaction of customary closing conditions, including receipt of required regulatory approvals and approval by Metsera’s shareholders.

Metsera confirmed in an October 30, 2025, press statement that it had received the unsolictied proposal from Novo Nordisk and that the proposal constituted a “superior company proposal” under its merger agreement with Pfizer. Metsera reported that under the terms of its merger agreement with Pfizer, receiving a “superior company proposal” triggers a four business-day period under which Pfizer has the right to negotiate with Metsera adjustments to the terms and conditions of its merger agreement. Metsera reported that Pfizer has informed Metsera that it does not believe Metsera has the right to deliver this trigger notice. Metsera disagrees with Pfizer’s view.

“The proposal [Novo Nordisk’s proposal] is illusory and cannot qualify as a superior proposal under Pfizer’s agreement with Metsera, and Pfizer is prepared to pursue all legal avenues to enforce its rights under its agreement,” said Pfizer in an October 30, 2025, press statement.

Under Metsera’s assertion, Pfizer would have four business days to adjust its offer for Metsera, after which time, Metsera says it would be entitled to terminate its merger agreement with Pfizer if determined by Metsera that Novo’s offer continues to constitute a “superior company proposal.”  Until then, the merger agreement between Pfizer and Metsera remains in effect, and Metsera’s Board of Directors reaffirmed its recommendation that the holders of Metsera common stock approve the merger with Pfizer, but that no action of Metsera shareholders is required at this time.

Novo Nordisk and Pfizer: Obesity drugs
For both Novo Nordisk and Pfizer, the acquisition of Metsera represents an opportunity for the companies to increase their positions in the obesity drug market. Pfizer’s interest in acquiring Metsera followed a setback earlier this year (April 2025) when Pfizer announced that it was discontinuing development of a late-stage drug candidate, danuglipron, an oral glucagon-like peptide-1 (GLP-1) receptor agonist, which was being investigated for chronic weight management, due to potential liver toxicity.

For Novo Nordisk, the acquisition would build on its position in the obesity drug market, which is part of a growth strategy as the company responds to a period of change. Last month (September 2025), Novo Nordisk announced a company-wide restructuring under which it will reduce its global workforce by approximately 9,000 of the 78,400 positions in the company, representing an approximately 11.5% reduction in its global workforce. The company said the restructuring is part of a strategy to simplify its organization, improve the speed of decision-making, and reallocate resources toward the company’s growth opportunities in diabetes and obesity. 

The announced restructuring was the first major move by Novo Nordisk’s new President and CEO Mike Doustdar, who took over the helm at the company in early August (August 2025), succeeding then CEO and President Lars Fruergaard Jørgensen. The company had announced in May (May 2025) that Jørgensen would be stepping down, then citing a need for a change in executive leadership amid challenging conditions. The company faced increased competition from its blockbuster drugs, Ozempic/Wegovy (semaglutide), GLP-1 agonists, respectively for treating Type 2 diabetes and obesity, potentially less than optimal results for its next-generation treatments, and a sharp decline earlier this year (2025) in the company’s stock price, according to analysts.

Metsera: what assets are at stake
Metsera has a portfolio of oral and injectable incretin, non-incretin, and combination therapy candidates, with four programs in clinical development and several programs with investigational new drug-enabling studies ongoing. These include: MET-097i, a weekly and monthly injectable GLP-1 receptor agonist, in Phase II development; MET-233i, a monthly amylin analog candidate being evaluated as a monotherapy and in combination with MET-097i in Phase I development; two oral GLP-1 receptor agonist candidates expected to begin clinical trials imminently (as reported on September 22, 2025); and additional preclinical nutrient-stimulated hormone therapeutics.

The competition in the obesity drug market
The leaders now in the obesity drug market are Novo Nordisk and Eli Lilly and Company, who battle one-to-one in both the diabetes and obesity market with Novo’s Ozempic/Wegovy (semaglutide), a GLP-1 agonist, and Lilly’s Mounjaro/Zepbound (tirzepatide), a dual-activating GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 medication, respectively for treating Type 2 diabetes and obesity. For both Novo Nordisk’s Ozempic/Wegovy and Lilly’s Mounjaro/Zepbound, the obesity indication is a key driver in realizing blockbuster status for these drugs, which are administered as injectables. Both companies also are moving forward with advancing oral obesity drugs.

Novo Nordisk is advancing an oral version of its obesity drug, Wegovy. Novo Nordisk already has an oral version of semaglutide, the active ingredient in Ozempic and Wegovy, on the market in Rybelsus, which was first approved in 2019, but that is indicated for treating Type 2 diabetes, not obesity. In May (May 2025), Novo announced that the US Food and Drug Administration (FDA) accepted its new drug application (NDA) submission for an investigational once-daily oral formulation of Wegovy (semaglutide) for chronic weight management in adults living with obesity or overweight with one or more comorbid conditions and to reduce the risk of major adverse cardiovascular events in adults with overweight or obesity and established cardiovascular disease. If approved, Wegovy would become the first oral formulation of a GLP-1 indicated for chronic weight management. The FDA action date to decide on the Wegovy oral formulation NDA is in the fourth quarter of 2025.

In addition, Novo Nordisk is advancing subcutaneous and oral amycretin into Phase III development in weight management based on completed clinical studies during the first quarter of 2025. Amycretin is a long-acting GLP-1 and amylin receptor agonist under development for treating adults with overweight or obesity and for Type 2 diabetes.

Novo Nordisk is also advancing CagriSema, a fixed-dose combination of a long-acting amylin analogue, cagrilintide, and semaglutide, the active ingredient in Wegovy and Ozempic. CagriSema is being investigated by Novo Nordisk as a once-weekly subcutaneous injectable treatment for adults with overweight or obesity (REDEFINE program) and as a treatment for adults with Type 2 diabetes (REIMAGINE program). To boost its obesity franchise further, its REDEFINE clinical trials have been initiated to investigate further the potential efficacy and safety of CagriSema. Also, semaglutide 7.2 mg (a higher dose of Wegovy) has been submitted to regulatory authorities in the European Union.

Longer term, Novo Nordisk is further building its pipeline of obesity drugs. In June (June 2025), Novo inked a deal worth up to $815 million with Deep Apple Therapeutics, a South San Francisco-based company specializing in small-molecule drug discovery to discover, develop, and commercialize oral small-molecule therapeutics directed at a non-incretin G protein-coupled receptors (GPCR) target for cardiometabolic diseases, including obesity, in a deal worth up to $812 million.

Lilly is advancing orforglipron, a once-daily oral small-molecule (non-peptide) oral GLP-1 receptor agonist, for treating Type 2 diabetes and obesity. Orforglipron was discovered by Chugai Pharmaceutical and licensed by Lilly in 2018. Chugai and Lilly published the preclinical pharmacology data of this molecule together, and Lilly is running Phase III studies on orforglipron for the treatment of Type 2 diabetes and for weight management in adults with obesity or overweight with at least one weight-related medical problem. It is also being studied as a potential treatment for obstructive sleep apnea and hypertension in adults with obesity. The company expects to submit to global regulatory agencies orforglipron in obesity by the end of 2025. 

Roche is advancing an oral GLP-1 receptor agonist, CT-996, which it gained through its 2024 acquisition of Carmot Therapeutics, a Berkeley, California-based bio/pharmaceutical company, in a deal worth up to $3.1 billion ($2.7 billion at closing plus $400 million in potential milestone payments). The acquisition provided Roche with three clinical-stage assets with potential in treating obesity and diabetes. These included CT-996, a once-daily oral small-molecule GLP-1 receptor agonist, in Phase I, for treating obesity in patients with and without Type 2 diabetes, as well as two injectable clinical drug candidates: CT-388, a once-weekly subcutaneous injectable in Phase II, for treating obesity in patients with and without Type 2 diabetes, and CT-868, a once-daily subcutaneous injectable, in Phase II, for treating Type 1 diabetes patients with overweight or obesity.

In addition, earlier this year (2025), Roche made another move for an obesity drug by forming an exclusive collaboration and licensing agreement with Zealand Pharma, a Søborg, Denmark-based bio/pharmaceutical company, to co-develop and co-commercialize Zealand Pharma’s petrelintide. Under the deal, the two companies will co-develop and co-commercialize petrelintide and potential combination products, including petrelintide/CT-388, aiming to establish the amylin-based franchise for weight management and related indications. The companies will share profits and losses on a 50/50 basis for petrelintide and petrelintide/CT-388 in the US and Europe, and Zealand Pharma is eligible to receive royalties on net sales in the rest of the world. Total deal consideration amounts to $5.3 billion, including upfront cash payments of $1.65 billion and potential development milestone payments of $1.2 billion, primarily linked to initiation of Phase II trials with the petrelintide monotherapy .In April 2025, Zealand Pharma initiated Phase II trials with petrelintide in people with overweight or obesity and Type 2 diabetes, investigating the efficacy and safety of petrelintide over a treatment duration of 28 weeks.

Among smaller companies, Viking Therapeutics, a San Diego, California-based clinical-stage bio/pharmaceutical company, is advancing a dual GLP-1/GIP agonist, VK2735, for treating obesity for both subcutaneous and oral administration. The oral formulation is in Phase II development, and the subcutaneous formulation is planned for Phase III testing in 2025. In March (March 2025), Viking Therapeutics signed a multi-year contract with the CDMO CordenPharma to provide development and manufacturing services for clinical and commercial scale (drug substance and drug product) of VK2735 for both the subcutaneous and oral peptide formulations.