New US$149‑a‑month GLP‑1 pills test how far employers will go on obesity benefits
A once‑daily obesity pill priced from US$149 a month is emerging as the next fault line in the GLP‑1 market – and it could force employer and plan sponsors to rethink how far they want to go on obesity coverage.
According to Reuters, Novo Nordisk now expects oral weight‑loss drugs to account for “up to a third‑plus” of the GLP‑1 market by 2030, a sharp shift from its earlier assumption that injectables would dominate.
The company links that change to a more consumer‑driven obesity market, where many patients pay out of pocket and prefer pills over injections.
As per CNBC, Novo Nordisk’s once‑daily Wegovy pill has launched in the US with cash prices of US$149 a month for the starting dose and up to US$299 for higher doses.
That sits slightly below the newly reduced cash prices for obesity injections, now about US$349 a month for Wegovy and US$449 a month for Eli Lilly’s Zepbound.
Goldman Sachs analysts expect oral GLP‑1s to capture roughly 24 percent of the global weight‑loss drug market by 2030 – about US$22bn – reported CNBC.
Those prices create a tension between retail and reimbursed markets.
CNBC reports that both Novo Nordisk and Eli Lilly will offer the starting dose of their pills for US$149 a month through US President Donald Trump’s direct‑to‑consumer TrumpRx website, while some insured patients can pay as little as US$25 a month for Novo’s oral drug.
However, John Crable, senior vice‑president at Corporate Synergies, told CNBC the direct‑to‑consumer price is likely “significantly less” than what employers and pharmacy benefit managers pay.
If payer prices mirror historical injection costs – often above US$1,000 a month – he said many employers will hesitate to add another high‑volume, high‑cost obesity drug to formularies.
CNBC also notes that some employers have dropped GLP‑1 coverage for obesity altogether because of cost.
On clinical performance, injections still lead.
Zepbound has delivered average weight loss above 20 percent in late‑stage trials, higher than results for both Wegovy injection and pill, as well as Eli Lilly’s oral GLP‑1, according to CNBC.
In those studies, about 7 percent or fewer patients discontinued Zepbound or Wegovy injections due to side effects, while similar rates appeared with the Wegovy pill and around 10.3 percent of patients on the highest dose of Lilly’s pill stopped treatment, reported CNBC.
Obesity specialist Caroline Apovian told CNBC she would only switch stable patients from injections to pills for cost reasons, saying that if cash prices are similar, she prefers injectables because “the weight loss is better and the side effects are less.”
Convenience is not straightforward either.
CNBC reports that some patients favour pills because they already take other oral medications and want to avoid refrigeration while travelling.
Others prefer a weekly injection because they find it easier to remember than a daily pill.
Novo Nordisk’s pill also requires patients to take it with no more than four ounces of water and wait 30 minutes before eating or drinking, whereas Eli Lilly’s small‑molecule pill orforglipron does not carry the same dietary restrictions, as per CNBC.
In separate late‑stage trials, CNBC says the highest Wegovy pill dose produced up to 16.6 percent average weight loss at 64 weeks, while the highest orforglipron dose delivered 12.4 percent at 72 weeks.
Analyst David Risinger told CNBC the two pills are still viewed as offering broadly similar weight‑loss outcomes.
Competition is intensifying.
Alongside Novo Nordisk and Eli Lilly, Pfizer, AstraZeneca, Structure Therapeutics and Viking Therapeutics are all developing oral GLP‑1s, reported CNBC.
Risinger expects the Novo and Lilly pills to “take off like a rocket,” with Lilly’s pill ultimately leading the daily oral segment.
According to CNBC, Goldman Sachs analysts forecast that Lilly’s pill could reach about 60 percent of the daily oral GLP‑1 market by 2030 (roughly US$13.6bn), with Novo’s oral semaglutide at 21 percent (around US$4bn) and the rest split among new entrants.
