Paging Dr. Frischer: Oral weight loss medications

Obesity medications have captured everyone’s attention. Novo Nordisk and Eli Lilly have each come out with injectable medications that have proven to be both safe and very effective. Doctors (including me) have been prescribing them frequently. However, patients are constantly frustrated by poor insurance coverage and high costs. On top of that, the drugs need to be injected, which is discouraging to some. 

These GLP-1 drugs were originally prescribed to treat type 2 diabetes, but have been found to not only stimulate the pancreas to release insulin when blood sugar rises, but also to slow stomach emptying and signal fullness to the brain. According to polls, some 6-12% of people in this country currently use GLP-1 drugs for weight loss or other chronic conditions.

Now, this is actually old news. What’s new? The FDA has announced the approval of a new Novo Nordisk weight loss drug that can be taken by mouth (instead of being injected) and should be available for a cash price starting at $149 to per month for the starting (lowest) dose. This is much more affordable than the current injectable version, which can cost $1,000 per month or more, and if it gets insurance coverage, then copays could be significantly lower. 

It appears that Novo Nordisk’s Rybelsus pill may be slightly less effective than its currently available injectable counterpart Wegovy. But the bottom line is that this new once-daily pill will be much cheaper and more accessible than the injectable medications. 

The competitor in this space is Eli Lilly, which makes Zepbound and Mounjaro. They too are working on an obesity pill using their GLP-1 drug, Tirzepatide. When it becomes available, the oral form will be Orforglipron. 

This is only the beginning. While Novo Nordisk got there first, the Eli Lilly competition is surely right behind. Both companies are also working on the next generation of these drugs, which will likely be even more effective. These are significant breakthroughs in the field of weight loss, and this is especially important because obesity leads to so many chronic diseases, including heart disease, diabetes, and degenerative arthritis. Yes, a healthful diet and active lifestyle are absolutely critical, but I am delighted to see this new tool available for those who wish to lose extra weight.