The US Food and Drug Administration approved, for the first time, an oral pill version of the blockbuster weight loss drug Wegovy, opening the door to a new form of treatment that could appeal to a broader population, particularly patients who are reluctant to use needles.
Until now, Wegovy has been available only as a once-weekly injection. Clinical trial data show that the pill version led to an average weight loss of about 13.6% of body weight over roughly 71 weeks, a result close to the roughly 15% average reduction seen with the injectable form. Physicians caution, however, that results in tightly controlled clinical trials do not always fully reflect real world use, where outcomes may be lower, and in some cases higher.
The pill is expected to be marketed in the US early next year. In Israel, it is expected to arrive only later in the year, and possibly not until 2027.
Unlike the injection, the oral version contains a significantly higher dose of semaglutide, the active ingredient also used in Ozempic and Wegovy. The higher dosage is required because only a small portion of the drug is absorbed when taken through the digestive system.
An oral semaglutide drug already exists. Rybelsus, primarily prescribed for diabetes, is taken in pill form but has a maximum dose of 14 milligrams and typically leads to more modest weight loss. The new Wegovy pill delivers 25 milligrams of semaglutide, compared with a maximum dose of 2.4 milligrams in the injectable version, and was developed specifically to treat obesity.
Advantages and drawbacks
One of the pill's main advantages is convenience, especially for patients who are afraid of needles or struggle to adhere to regular injections. On the downside, the pill must be taken immediately upon waking, on an empty stomach, with no food or drink for 30 minutes afterward. Some physicians believe this requirement could make long-term adherence more difficult.
A competing drug, orforglipron, developed by Eli Lilly and expected to reach the market in the coming months, is not expected to carry similar restrictions, which could give it a significant advantage over the Wegovy pill.
In terms of safety, side effects observed with the pill were similar to those seen with injectable GLP-1 drugs, primarily nausea and vomiting. In Wegovy's clinical trial, about 7% of participants discontinued treatment due to side effects, a rate similar to that seen in the placebo group. Trials of orforglipron showed a slightly higher discontinuation rate.
What will it cost?
Producing pills is generally cheaper than manufacturing injectable drugs. The company said the lower-dose Wegovy pill will be sold in the US for about $149 per month. Pricing details for higher doses are expected to be released later. It is still unclear what the price will be in Israel.
