The anti-obesity market is undergoing a major shift as pharmaceutical companies push oral medications – pills – as a more accessible alternative to injectable weight-loss drugs. This move is expected to significantly expand the reach of these treatments, with analysts calling 2024 a “pivotal” year for the industry.
The Rise of Oral GLP-1s
For years, weight-loss injections like Eli Lilly’s Zepbound and Novo Nordisk’s Wegovy have been gaining traction. However, the introduction of daily oral versions, such as Novo Nordisk’s Wegovy pill, is changing the landscape. The pill mimics the gut hormone GLP-1, which regulates appetite, and has seen remarkably fast adoption in the US, with 50,000 prescriptions filled weekly by late January – surpassing initial demand for the injectable version.
This rapid uptake reflects a simple preference: pills are easier to take than injections. As Melody Ewert, a 44-year-old from Minnesota, explains, “I just felt slow… I want to be able to do anything my kids want to do and not have weight be a factor.” Ewert switched to the pill after her insurance coverage changed, making the injection prohibitively expensive. She now pays $449 a month for Zepbound instead of $25.
Market Dynamics and Challenges
The weight-loss drug market is projected to reach $200 billion by the end of the decade, but growth isn’t without obstacles. Price remains a major concern, with many patients forced to pay out of pocket. Supply chain issues and potential side effects also loom large. Despite these hurdles, demand is surging, driven by factors like increasing obesity rates and growing acceptance of medical intervention for weight management.
A study by UCL researchers found that 1.6 million adults in England, Scotland, and Wales used weight-loss drugs between early 2024 and early 2025, with nearly two-thirds of adults overweight or obese in England in 2022. The study also found that 3.3 million more people would like to use such medications, especially those struggling financially.
Pharma Competition and Innovation
Novo Nordisk and Eli Lilly are leading the charge, with Lilly preparing to launch its own oral drug, orforglipron, in April. Unlike Novo’s pill, orforglipron is a small molecule that doesn’t require fasting before taking it. Many patients already prefer Eli Lilly’s Mounjaro over Wegovy due to greater weight loss in clinical trials.
Competition is intensifying. AstraZeneca is developing new drugs targeting the hormone amylin for even more effective weight loss, while smaller biotech firms like Structure Therapeutics and Viking Therapeutics are also in the race. The US Medicare program will begin covering GLP-1 medications in April, further expanding access.
Long-Term Prospects and Concerns
Despite cost-effectiveness concerns – researchers at the University of Chicago Medicine found that GLP-1 injections don’t meet government benchmarks due to their high price – the shift to pills could change the equation. Pills may be more affordable for governments and attract new patients who are hesitant about injections. However, the long-term effects of these drugs are still under scrutiny. Studies show that people regain weight if they stop taking GLP-1 medications, and experts have raised concerns about potential side effects, including gallbladder issues.
Ultimately, the expansion of weight-loss drugs from injections to pills is a transformative moment for the pharmaceutical industry and public health. It’s a sign of a growing market driven by demand, innovation, and a willingness to address obesity as a medical condition rather than a lifestyle issue.
