New daily diet pills, offering oral alternatives to popular weight-loss injections, are entering the market, potentially expanding access to GLP-1 agonist treatments for weight management. These new formulations aim to replicate the appetite-suppressing and gastric-emptying effects of their injectable counterparts.
One such option is the oral version of Wegovy, containing semaglutide, the same active ingredient used in the injectable form. The pill version was approved by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK earlier this month and is available privately at approximately £100 per month. In the United States, the Wegovy pill received approval earlier this year and saw three million prescriptions in its first five months.
Like the jab, the Wegovy pill works by mimicking GLP-1 gut hormones to reduce appetite and slow digestion, promoting a feeling of fullness. A key difference is the inclusion of a carrier molecule, salcaprozate sodium (SNAC), which protects the drug from stomach acid, allowing for absorption into the bloodstream. Trial data suggests an average weight loss of 16.6 percent of body weight over 64 weeks at the highest dose. Participants also experienced improvements in HbA1c levels, blood pressure, and waist circumference. Gastrointestinal side effects, such as nausea and vomiting, were reported in 74 percent of trial participants, with 7 percent discontinuing the medication due to these effects.
Another emerging product is Foundayo, an oral version of drugs produced by the company behind Mounjaro, which contains orforglipron. This drug is also a small molecule that mimics GLP-1. It is designed to be taken once daily at any time, without the need for specific timing relative to meals. Clinical trials indicate an average weight loss of 12.4 percent of body weight over 18 months. Foundayo has also shown benefits in reducing waist circumference and lowering systolic blood pressure. Side effects, including nausea and diarrhea, have been reported in 5 to 10 percent of patients, leading to discontinuation in some cases. Foundayo is expected to become available in the UK later this year.
While the Wegovy pill offers potentially greater weight loss than Foundayo, it requires daily intake and must be taken at least 30 minutes before eating. Foundayo's convenience in being taken at any time, coupled with its simpler manufacturing process as a small molecule drug, may lead to a lower cost in the long term. However, Foundayo is associated with slightly less average weight loss compared to the Wegovy pill. Both oral medications require daily administration, a departure from the weekly dosing of their injectable predecessors.
Availability on the UK's National Health Service (NHS) for both medications would necessitate appraisal by the National Institute for Health and Care Excellence (NICE). The earliest potential prescription on the NHS for the Wegovy pill is estimated to be 2027, with Foundayo's timeline also dependent on regulatory reviews.