In a significant development for obesity treatment, the US Food and Drug Administration (FDA) has approved the first daily oral medication for obesity, a pill version of the popular weight-loss drug Wegovy. This approval provides Danish pharmaceutical giant Novo Nordisk a competitive edge over its main rival, Eli Lilly, in the burgeoning market for obesity treatments.
The FDA’s decision comes as Eli Lilly’s oral drug, orforglipron, remains under review. Both medications belong to the GLP-1 (glucagon-like peptide) class of drugs, which emulate a natural hormone that regulates appetite and satiety, similar to injectable treatments that have gained widespread use in recent years.
Revolutionizing Obesity Treatment
Novo Nordisk’s injectable version of Wegovy, alongside Eli Lilly’s Zepbound, has already transformed the landscape of obesity treatment, particularly in the United States, where approximately 100 million individuals are affected by this chronic condition. The introduction of an oral option is expected to expand the market further by enhancing accessibility and potentially reducing costs.
According to company officials, the Wegovy pills will be available within weeks. This move is anticipated to address affordability issues faced by many Americans who struggle with the high costs of injectable GLP-1 drugs. A nonprofit health policy research group reports that about one in eight Americans have used these injectables, but the financial burden remains a significant barrier.
“There’s an entire demographic that can benefit from the pills,” said Fatima Cody Stanford, an obesity expert at Massachusetts General Hospital. “For me, it’s not just about who gets it across the finish line first. It’s about having these options available to patients.”
Economic Implications and Market Strategy
The Wegovy pill contains 25 milligrams of semaglutide, the same active ingredient found in the injectable versions of Wegovy and Ozempic, as well as in Rybelsus, a lower-dose pill used for diabetes treatment. While all GLP-1 drugs share common side effects like nausea and diarrhea, the cost of producing pills is generally lower than that of injectables, potentially leading to more affordable pricing for consumers.
Earlier this year, the Trump administration announced negotiations with drug manufacturers to lower the prices of GLP-1 drugs, which can exceed $1,000 per month. As part of a November agreement, Novo Nordisk and Eli Lilly committed to offering starter doses of their weight-loss pills, if approved, for $149 per month to US Medicare and Medicaid patients, as well as cash-paying customers lacking insurance coverage.
Pills or Needles?
The debate over whether patients will prefer daily pills or weekly injections remains unresolved. While some individuals have an aversion to needles, others do not mind the weekly regimen of injections. Angela Fitch, chief medical officer of health care company knownwell, emphasizes that the primary benefit of these medications lies in their increased accessibility and affordability.
“It’s all about the price,” Dr. Fitch stated. “Just give me a drug at $100 a month that is relatively effective.”
In the United States, where drug pricing is managed through health insurance plans, attracting cash-paying consumers is crucial for the success of these pills. David Moore, a US executive at Novo Nordisk, indicated that the company plans to offer a self-pay option “from day one for US patients.”
Strategic Launch and Market Competition
Novo Nordisk intends to distribute the Wegovy pill through various channels, including retail pharmacies, online platforms, and telehealth partners, allowing patients to begin treatment without waiting for insurance coverage. This strategy aims to rejuvenate Novo’s slowing sales growth and propel the next phase of expansion in the obesity drug market.
Despite facing increased competition from Eli Lilly’s Zepbound and pressure from cheaper, unapproved compounded versions of semaglutide, Novo Nordisk is optimistic about the potential of the once-daily oral dose of Wegovy to attract new patients who may have been reluctant to start treatment with injections.
“We’ve never launched this way before,” said Mr. Moore. “In the past, the mindset was more traditional — the product is available, you wait for insurers to cover it, and it’s at the retail pharmacy.”
Jason Brett, Novo’s US medical head, believes the pill could expand access by offering doctors more prescribing options and meeting patients “where they are” through telehealth. Analysts and industry experts predict that while oral GLP-1s may not completely replace injections, they could capture up to 20 percent of the global obesity drug market by 2030.
“There are people who are needle-phobic, people who develop ‘injection fatigue,’ and people who don’t see themselves as sick and feel an injectable is too serious,” noted Zachariah Reitano, CEO of telehealth company Ro. “For all of them, a pill is a much easier on-ramp.”
As Novo Nordisk prepares to launch its Wegovy pill, the company is poised to capitalize on the growing demand for more convenient and affordable obesity treatments, potentially reshaping the future of this critical healthcare sector.
