FDA approves pill form of Ozempic/Wegovy

Does your New Year’s resolution involve a newfound focus on health or weight loss?

Well, you may be excited to hear that the traditional GLP-1 injectables will now be available in pill form. The FDA has approved the oral Wegovy/Semaglutide from Novadisk, and it will be available at local pharmacies in January. Meanwhile, Orforglipron, a second oral GLP-1 produced by Lily, is estimated to be released as early as March of 2026.

One of the primary advantages of oral GLP-1 medications is ease of administration. Injectable formulations require patients to learn to self-administer injections, which can be an obstacle for patients who are hesitant about needles. Meanwhile, oral medications can be taken similarly to traditional pills, making it easier to incorporate them into a patient’s daily routine.

From a cost perspective, while both oral and injectable GLP-1 medications can be expensive, the oral versions are less expensive to produce, which should help reduce their total cost. The starting dose of Wegovy will cost $149/month, with higher doses priced at $299/month. The expected cost of Orforglipron has not been released.

However, under a new arrangement with the government, pharmaceutical companies have agreed to sell the starting doses of oral Wegovy and Orforglipron at $149/month for Medicare and Medicaid participants and cash payers through the TrumpRx website. It is scheduled to launch this month.

In terms of effectiveness, both oral and injectable GLP-1 medications have demonstrated significant benefits in glycemic control and weight management. However, recent studies indicate that individuals taking oral Wegovy/Semaglutide lost an average of 13.6% of their initial weight, while those taking Orforglipron lost 12.4%. This was slightly lower than injectable Wegovy, which was associated with an average 15% weight loss from baseline, and Tirzepatide/Zepbound, which was associated with a 20% weight loss.

Oral GLP1’s have also been associated with more GI issues, such as nausea and diarrhea, due to their stomach absorption. Meanwhile, the GLP-1 injectables have been more frequently associated with local site reactions (redness and itching), but offer more consistent drug levels, which could lead to greater efficacy.

However, recent studies using Orforglipron have shown great promise for effective weight maintenance. This may make oral GLP- 1s an effective, more affordable option for stabilizing a patient’s weight after achieving their goal weight with GLP-1 injectables or, in some cases, bariatric surgery. Therefore, combining injectable, surgical and oral therapies may be the future approach to achieve greater weight loss while maintaining the long-term convenience of oral therapy.

In summary, as the landscape of diabetes and obesity continues to evolve, oral GLP-1 medications may play a crucial role in enhancing patient adherence and overall treatment outcomes. Oral GLP-1 medications may offer distinct advantages for patients over their injectable counterparts, including ease of administration, potential cost savings and comparable effectiveness.

Dr. Maurie Patterson-Rosen specializes in internal medicine at Willis Knighton Internal Medicine Pierremont. She is board certified in obesity medicine by the American Board of Obesity Medicine and is medical director of Metabolic Disease and Obesity Clinic at Willis Knighton.