New weight-loss pills could soon be approved

According to a recent KFF poll, one in eight people are currently taking an injectable GLP-1 drug. Although these drugs are effective, they require weekly injections and can be expensive, especially without insurance.

However, patients could soon access new, cheaper versions of these drugs. Currently, both Novo Nordisk, which manufactures Ozempic and Wegovy, and Eli Lilly, which manufactures Mounjaro and Zepbound, are preparing new, daily GLP-1 pills for FDA approval.

Novo's new GLP-1 pill is an oral formulation of semaglutide, the main ingredient in Ozempic and Wegovy. In a late-stage clinical trial, participants taking oral semaglutide achieved an average weight loss of 16.6% over 64 weeks compared to 2.7% for those taking a placebo — results that were comparable to injectable semaglutide. The pill also improved participants' physical activity levels and cardiovascular risk profiles.  

Novo has submitted oral semaglutide for FDA approval, with a decision expected before the end of the year. If approved, the company could launch its new GLP-1 pill in early 2026.

Meanwhile, Eli Lilly is currently working on a new GLP-1 pill called orforglipron. Instead of using the same ingredient in Mounjaro and Zepbound, the new pill has a different active ingredient. In a clinical trial, patients who took orforglipron achieved an average weight loss of 12.4% over 72 weeks.

Although orforglipron was less effective than oral semaglutide in clinical trials, orforglipron does not have any food or water restrictions for patients taking it, which may make it more convenient to take.

Eli Lilly has not yet submitted orforglipron for FDA approval but plans to do so before the end of the year. Because the company received a priority review voucher, FDA will decide whether to approve the drug "within months."

Compared to injectable medications, pills are cheaper to manufacture and ship since they don't require refrigeration. This means the new GLP-1 pills will likely be cheaper than their injectable counterparts, which could increase access to the medication.

"It's easier to manufacture and the cost ultimately should be lower," said Richard Siegel, codirector of the Diabetes and Lipid Center at Tufts Medical Center. "One of the big problems with all of the medicines in this arena has been the cost. And can we equitably get these medicines to the millions, really, of people who might benefit from them?"

The Trump administration has also already reached a deal with both Novo Nordisk and Eli Lilly to offer discounts on their new GLP-1 pills once they've been approved by FDA. If approved, the companies would offer their new pills directly to consumers for $150 a month.

The future of GLP-1 drugs

Aside from oral GLP-1 drugs, drugmakers are also working on next generation medications that target more hormones and produce even greater weight loss.

For example, Eli Lilly is developing a new drug called retatrutide that targets three different gut hormones instead of just one or two. In a clinical trial, patients who took the highest dose of retatrutide lost an average of 24.2% of their body weight over 48 weeks. According to researchers, this weight loss could be even greater over more time.

Currently, Eli Lilly is waiting for results from several major clinical trials for the drug before it seeks FDA approval. The results from these trials are expected by the end of next year. 

Separately, Novo Nordisk is working on an experimental drug called CagriSema, which combines semaglutide with a compound that mimics the gut hormone amylin. In a clinical trial, patients who took CagriSema lost an average of 20% of their body weight, or 5% more than semaglutide alone. Novo Nordisk plans to seek FDA approval for CagriSema next year.

Other drugmakers, including Amgen and Metsera, are also working on their own experimental weight-loss drugs. Pfizer recently agreed to acquire Metsera for $10 billion, beating out Novo Nordisk.

Although several new GLP-1 drugs are on the way, researchers say the original injectable drugs could remain popular. Compared to newer drugs, there are years of safety data on the original GLP-1 medications.

Injectable GLP-1 drugs have also been approved for use outside of diabetes or weight loss. Wegovy is approved to reduce cardiovascular risk, as well as to treat metabolic associated steatohepatitis (MASH), or a severe form of fatty liver disease. Zepbound has also been approved to treat sleep apnea.

"That is the hurdle that any other class is going to have to jump over to show that you can reduce the risk of heart attack, stroke and dying," said Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine.

Overall, "[h]aving more options … creates a space where there's more competition," which could help lower costs and make GLP-1 drugs more accessible, said Ania Jastreboff, director of the Yale Obesity Research Center.

Advisory Board's weight-related resources

To help you address the growing use of weight management drugs, Advisory Board offers several resources:

This expert insight outlines the five biggest questions about weight management drugs and their answers. Similarly, this expert insight addresses what headlines get wrong about weight management drugs and what healthcare leaders should know instead.

Radio Advisory's Rachel Woods has also covered GLP-1 drugs on the podcast, discussing the potential future of these drugs and how they could help — or hurt — health systems' finances. Other useful resources include this expert insight on the five catalysts that will impact the future of obesity care and this research on four key elements of comprehensive obesity care.

Our weight management and obesity care resource library can also help leaders understand the current care landscape, manage innovations, and prepare for transformations in care.