Oral GLP-1s are set to shake up the weight-loss drug market, with Foundayo, launched by Eli Lilly in early April, already making waves across the U.S. But given past struggles to meet demand, industry onlookers will be wondering how these new tablets might impact healthcare supply chains.

Pharmaceutical companies have faced persistent challenges in delivering injectable GLP-1s to doctors and patients since the drugs became mainstream for weight loss in the early 2020s. A sharper-than-expected rise in demand led to waves of shortages, peaking in 2023 and 2024, as polls indicated that 1 in 8 people in the US used GLP-1s. 

Initial constraints have eased as the market size became clear and supply more manageable. But with new tablets launching in the U.S. – Foundayo joins oral Wegovy from Novo Nordisk on the market – will this change disrupt the supply status quo that had emerged?

Much of the concern surrounding oral GLP-1s is on the demand side. The presumption is there might be a spike comparable to the initial increase in usage in 2023 and 2024. However, the market is now in a very different position, with demand proving strong and steady, and a natural limit to uptake. 

For patients and prescribers who strongly prefer a pill over a needle, the launch of Foundayo could still meaningfully shift behavior. Consequently, the shape of GLP-1 demand may prove to be more important than the overall level of demand – being another oral option in a category that until recently, has been dominated by injections. 

There’s nevertheless some debate over whether drugs like Foundayo land at the same efficacy level as some of the injectable GLP‑1s. It’s early days, but if that holds, it will probably cap how much it can pull the market toward it. In short, the picture is more complex than just expecting a big increase in demand.

While debate focuses on how demand may be affected by a lower barrier to entry for patients less keen on injections, there’s a corresponding supply-side benefit to the new format that’s commonly overlooked.

In part, the 2023-24 crunch was made worse because the market was dominated by injectables, which meant GLP-1 producers needed not only drug supply, but also injection-specific components and presentation materials. This includes packaging and needles. That’s effectively two supply chains that both had to scale at once.

With oral GLP‑1s making up a greater share of overall production, there’s simply less complexity, and that should reduce the odds of a severe, system-wide bottleneck like the one we saw in the past. What’s more likely is territory-by-territory tightness, as shortages may emerge depending on how demand ramps and how supply is distributed market to market.

While oral GLP-1s reduce some of the complexity that strained supply chains in 2023 and 2024, they don’t remove the underlying question marks over how manufacturing capacity is growing or adapting.

Eli Lilly has announced a number of new U.S. manufacturing facilities, but these are expected to come online between 2027 and 2031. In the long term, oral GLP-1s may be an early signal of how high-value therapies are manufactured in the future — not purely based on cost, but where supply can be delivered most reliably. This onshoring effort brings tighter quality control and closer alignment between production and regulators like the FDA. But it does little to ease pressure in the near term.

That leaves a more pressing question for Foundayo. Is its rollout being supported by genuinely expanded capacity, or by reallocating existing production, either internally or through contract manufacturers? If the latter, then any strain might not appear in GLP-1 supply itself, but could instead become apparent elsewhere in the portfolio.

With plans to launch to around 40 countries, plus oral Wegovy having a head start, execution and consistency of supply will define Foundayo’s success. Early indications are that the launch should be more stable than the shortages that defined the early GLP-1 surge, with supply chains better prepared and, presumably, some degree of slack in production capacity. Confidence is such that Amazon has announced a partnership with Eli Lilly to deliver Foundayo same-day.

But uncertainty still sits beneath the surface. How demand evolves and how easily global manufacturing scales will determine whether this remains a smooth rollout or creates pressure elsewhere. Oral GLP-1s may reduce some of the complexity that drove past bottlenecks. But they also raise the stakes, acting as a broader test of pharma supply chain resilience with implications for how other high-value therapies are launched.

Jenna Fink is senior director, research & advisory at Zero100.