“The pill is here,” Novo Nordisk’s CEO Mike Doustdar has announced in a statement after their Wegovy pill gained FDA approval over the holidays.
In recent years, the boom in obesity drugs has left pharma giants Novo Nordisk and Eli Lilly in a global battle to win dominance of the market. With huge fortunes at stake – the market is expected to grow from $6.15 billion in 2024 to just under $38 billion by 2032 – both companies have been in a race to bring the first semaglutide weight loss pill to patients.
Renowned weight loss medicines like Wegovy and Zepbound have always been administered as weekly injections. But now that the first pill is due to become available later this month, there will likely be an influx of demand for this easy-to-take oral method.
Lilly’s competitor pill is yet to gain approval but is predicted to hit the market in about four months' time after hitting a ‘maintenance’ mark in a recent trial.
Below we’re diving into what this shift in obesity treatment means for the market and, more importantly, for those relying on semaglutide therapies to lose weight.
With an ongoing obesity crisis and as many as 1 in 8 people living with obesity (and its associated health risks), the use of GLP-1 injectables has skyrocketed in recent years. Thanks to their appetite-reducing abilities, the likes of Wegovy and Zepbound have provided a short-term solution for dropping pounds both quickly and without the need for lifestyle changes.
But for some, injections can be daunting and time-consuming – or a reason to avoid the drug altogether. Pills, on the other hand, are more user-friendly, and as a result, are expected to capture around 20% of the $80 billion obesity GLP-1 market by the end of the decade.
Novo’s approval marks a pivotal moment in obesity drugs and the future of the market. Especially as Wegovy pills are to be sold cheaper than their injectable counterparts.
While semaglutide has existed in pill form for diabetic patients since 2019, the Wegovy pill is the first GLP-1 tablet to gain FDA approval specifically for weight loss.
With Lilly’s competitor pill also expecting to hit the market later this year, there will likely be an increase in appetite for these weight loss products, particularly for those with a fear of needles and those with lower budgets.
Novo’s pill approval marks a ‘paradigm shift in obesity treatment’, according to a report written by BioPharma Dive. The tablet version of their lead product Wegovy is a higher-dose version of their oral GLP-1 Rybelsus, which has only been FDA-approved for patients with diabetes.
The Wegovy pill, however, means weight loss patients can also benefit from a daily dose of semaglutide. And unlike Rybelsus – which has a maximum maintenance dose of 14 mg – the new pill dosage goes as high as 25 mg.
This is more than 50 times the amount of their highest-dose weekly injection, primarily because of how difficult it is to get GLP-1 drugs into the blood stream via the digestive system.
The Wegovy pill must be taken on an empty stomach every morning, followed by a strict wait time before eating. So, while it may be easier to swallow pills, taking this form of semaglutide could require more thought and discipline.
Although Lilly is currently behind Novo in this anti-obesity drugs race, it’s thought that their weight loss pill could hit the market in as little as a few months.
According to CNBC, the company filed for FDA approval of their daily GLP-1 pill last year and was ‘awarded a priority review voucher which could expedite its review timeline’.
Lilly’s pill, orforglipron, also contains the active ingredient semaglutide. However, unlike the Wegovy pill, it is a chemical or small molecule drug that requires less complex manufacturing and therefore reaps benefits in cost, efficiency and accessibility.
According to the company, in clinical trials orforglipron was taken once a day at any time and without any food or water restrictions. This may appeal to a wider audience of patients and potentially generate more success than their rival in the long run.
There is also hope that orforglipron will act as a more tolerable alternative to injectables, with many stopping the likes of Wegovy and Zepbound within a year due to their unpleasant side effects.
