Novo Nordisk launches first GLP-1 pill for weight loss

The medication, a Wegovy tablet taken once daily, was approved by FDA in December for both weight loss and cardiovascular risk.

The starting dose of the pill is 1.5 milligrams and is currently available across more than 70,000 U.S. retailers and pharmacies, including CVS and Costco, along with telehealth providers like Ro, LifeMD, Weight Watchers, GoodRx, and Novo Nordisk's NovoCare Pharmacy. Higher doses of the pill will be available by the end of the week, according to Novo Nordisk.

According to Jason Brett, principal U.S. medical head for Novo Nordisk, the medications are designed to start at a low dose and have patients gradually ramp up their dosage over time to manage side effects. The Wegovy pill will come in doses of 1.5 milligrams, 4 milligrams, 9 milligrams, and 25 milligrams, he said.

The prices range from $149 a month for the initial 1.5-milligram dose, to $299 per month for the 25-milligram dose.

Novo Nordisk says the Wegovy pill must be taken on an empty stomach with a small amount of water. Patients should not eat, drink, or take any other medications for 30 minutes after taking the medication.

In a clinical trial, Novo Nordisk found that participants taking the highest dose of the Wegovy pill lost an average of around 14% of their body weight over 64 weeks, which was around 12% more than patients who received a placebo.

Eli Lilly also has a GLP-1 pill called orforglipron. In a study of 3,127 patients at its highest dose, the medication helped participants lose an average of 12.4% of their body weight at 72 weeks. Orforglipron can be taken once a day at any time without any restrictions on food or water, according to Eli Lilly. The drugmaker is seeking an expedited FDA review of orforglipron that could result in approval early this year.

Discussion

Drug companies and analysts said GLP-1 pills will tap into demand from patients who don't want an injection or prefer taking a daily dose of a medication. Pills also offer the potential for lower prices and better health insurance coverage than injections, as pills cost less to make.

"We believe it will expand access and options for patients," Brett said. "We know there are some patients who just won't take an injectable medication."

David Risinger, an analyst at Leerink Partners, estimated that pills will ultimately make up around 25% of the projected $150 billion total obesity-drug market.

Evan Seigerman, a financial analyst at BMO Capital Markets, said he anticipates that doctors and patients will turn to GLP-1 pills for weight maintenance after they've reached a weight-loss plateau on injectable drugs.

Meanwhile, Judith Korner, an endocrinologist and director of the Metabolic and Weight Control Center at Columbia University Vagelos College of Physicians and Surgeons, said there are three major considerations for determining whether any new medications are right for her patients: how well they work, how safe and tolerable they are to take, and their cost.

"The Wegovy pill doesn't seem to be moving the needle that much with regard to any of the above," she said.

However, Korner said she does applaud having more options for patients in a group of medications that have proven to be beneficial beyond just weight loss.

"As we start seeing these benefits, like for people who've had cardiac disease, 20% reduction in death or another event; reduction in sleep apnea; reduction in heart failure; improved liver function, that's, to me, the exciting part," she said.

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.