Eli Lilly and Novo Nordisk can't manufacture their way out of the GLP-1 shortage alone, and Washington just made sure they won't have to. Novo Holdings' $16.5 billion buyout of Catalent handed Novo three fill-finish plants; Lilly has publicly farmed out tirzepatide drug-product work to outside CDMOs while it builds its own Indiana, Texas, and Alabama sites. Layer on the White House's April 2026 Section 232 proclamation — a tariff regime that defaults to 100% duties on imported pharmaceuticals and APIs starting July 31, 2026, but forgives companies that sign onshoring agreements — and the incentive is explicit: build sterile injectable capacity in the U.S., or pay for it at the border. Neither Lilly nor Novo can absorb enough of that build-out internally on the timeline Ozempic-and-Zepbound demand demands. That gap gets filled by contract manufacturers, and it doesn't matter whose molecule wins the obesity market — someone still has to fill the pen.