According to experts, the emergence of pills for the treatment of obesity could significantly expand the market for these therapies, improving their accessibility and reducing financial costs, as reported by Euronews.
On Monday, the U.S. Food and Drug Administration (FDA) approved the tablet version of Wegovy, one of the leading weight loss drugs, making it the first daily oral medication for the treatment of obesity.
This decision gives Novo Nordisk an advantage over Eli Lilly, whose oral drug orforglipron is still under review.
Both medications belong to the GLP-1 class and work similarly to injectable drugs, mimicking a hormone that regulates appetite and feelings of fullness.
In recent years, the injectable forms of Wegovy from Novo Nordisk and Zepbound from Lilly have significantly changed the approach to treating obesity in the U.S. and around the world, where about 100 million people suffer from this chronic disease.
Representatives of Novo Nordisk stated that Wegovy tablets will be available for sale in the coming weeks.
Experts are confident that the new oral medications will be able to expand the market for combating obesity, improving accessibility and reducing treatment costs.
According to a KFF survey, about one in eight Americans has used GLP-1 injectable medications, but many cannot afford the expensive injections.
“There are people who could significantly benefit from the emergence of pills,” noted Fatima Cody Stanford, an obesity expert from Massachusetts General Hospital. “It's important not only who gets to market first but also that patients have different treatment options.”
The Wegovy tablet from Novo Nordisk contains 25 milligrams of semaglutide, which is also used in the injectable Wegovy and Ozempic, as well as in Rybelsus, a lower-dose tablet approved for diabetes treatment in 2019.
In a clinical trial, participants taking oral Wegovy lost an average of 13.6% of their initial body weight over approximately 15 months, while those receiving a placebo lost 2.2%. This is comparable to injectable Wegovy, where the average weight loss reaches 15%.
Chris Mertens, a 35-year-old pediatric pulmonologist from Menomonee Falls, took Wegovy tablets as part of a Novo Nordisk study in 2022 and lost about 40 pounds. He noted that taking the pills daily significantly reduced his appetite and decreased obsessive thoughts about food.
“I sometimes skipped meals and hardly noticed it,” Mertens said.
Participants in the clinical trial who used the maximum dose of Lilly's orforglipron lost an average of 11.2% of their body weight over nearly 17 months, compared to 2.1% in the placebo group.
However, both medications demonstrated lower effectiveness compared to Lilly's Zepbound, which acts on two intestinal hormones, GLP-1 and GIP, and provides an average weight loss of about 21%.
All GLP-1 medications, both oral and injectable, have similar side effects, including nausea and diarrhea.
Both daily tablets offer convenience, but Wegovy should be taken in the morning on an empty stomach, with a small amount of water, and wait 30 minutes before eating or drinking.
This is because Novo Nordisk designed the tablet to avoid breaking down in the stomach before the active ingredient enters the bloodstream. To achieve this, a component was added to protect the drug in the intestine for about 30 minutes.
Unlike Wegovy, Lilly's orforglipron does not have such restrictions on the dosing schedule. This drug is being considered under a new FDA program aimed at accelerating the drug approval process, with a decision expected by spring.
Producing tablets is generally cheaper than injectable forms, so the cost of the new oral medications may be lower. Earlier this year, the Trump administration reported that it was working with pharmaceutical companies to reduce the prices of GLP-1 drugs, which can cost over $1,000 (about €848) per month.
According to the company, the starting price of the tablets will be $149 (about €126) per month from some suppliers. Further pricing details are expected in January.
It is unclear what patients will prefer: daily tablets or weekly injections.
Obesity treatment experts note that some patients dislike injections, while others are comfortable with weekly shots. Mertens, for example, switched to the injectable Zepbound after completing the clinical trial when he began to regain weight.
He noted that he appreciated the discipline provided by taking the pills daily.
“It was a sort of conscious action that reminded me: today I take my medication, so my decisions will be different,” he added.
Angela Fitch, an obesity expert and chief medical officer at knownwell, noted that regardless of the form, the main goal is to make weight loss medications more accessible and affordable.
“Price is a key factor,” she emphasized. “Give me a drug for $100 (about €84) a month with relative effectiveness, and I will be satisfied.”
