Weight-Loss Pill Battle Heats Up

Novo Nordisk is regaining some of its market share in the rapidly expanding weight-loss drug market with its recently approved Wegovy pill.

Oral Wegovy (semaglutide) is a once-daily, needle-free medication approved by the FDA for chronic weight management in adults with obesity or overweight. Studies show the pill can produce weight loss of about 17%, similar to the injectable version.

The Danish drugmaker had fallen behind rival Eli Lilly in the booming market for GLP-1 weight-loss medications. But after the pill’s approval in late December, demand quickly surged. According to the Financial Times, U.S. physicians had written more than 300,000 prescriptions by the end of February, helping Novo Nordisk regain ground in the competition.

Brian Lian of Viking Therapeutics, a San Diego biotechnology company developing weight-loss drugs, called the Wegovy pill “the fastest drug launch in history,” adding that there is still an “extraordinary demand for these therapies.”

The competitive battle is now shifting from injections to pills. Novo Nordisk’s oral Wegovy was the first to reach the market, but Eli Lilly’s pill version, called orforglipron, is expected to receive regulatory approval as early as April.

Over the past year, Novo Nordisk’s market share declined despite the success of Ozempic. Meanwhile, Eli Lilly’s drug tirzepatide — sold as Zepbound for weight loss and Mounjaro for diabetes — has become one of the world’s top-selling drugs, helping Lilly take the lead.

Novo Nordisk has since revamped its marketing and sales strategy to ensure that the easy-to-use Wegovy pill is widely available as the company works to recover some of the market share lost to Lilly. If orforglipron gains approval, however, the competition between oral weight-loss drugs is expected to intensify.

PATENT EXPIRATION

Another challenge for Novo Nordisk is patent protection. Semaglutide, the active ingredient in Wegovy and Ozempic, will soon lose patent protection in several countries, including India, China, Brazil, and Turkey. The patent has already expired in Canada, the world’s second-largest market for weight-loss and diabetes drugs.

Manufacturers in several countries have already filed applications to produce generic versions once patent protections expire, a move that could significantly lower the price of these medications.

PILL DETAILS, COSTS

There are also practical differences between the pills. Wegovy must be taken on an empty stomach with a small amount of water — up to 4 ounces — and patients must wait at least 30 minutes before eating, drinking other beverages, or taking additional medications. Lilly’s pill orforglipron does not have the same restrictions.

Price may also drive demand. Many patients are switching from injections to pills because they are less expensive.

The lowest 1.5 milligram dose of the Wegovy pill costs about $149 for a month’s supply, while injectable weight-loss medications can cost as much as $1,300 a month without insurance. With insurance, some patients may pay as little as $25 per month for the pill. Eli Lilly has said its orforglipron pill could start around $149 a month, with higher doses costing up to $399.

As more consumers enter the market for weight-loss medications, experts say the competition between manufacturers of weight loss pills will continue to grow.