Wegovy pill now selling as Eli Lilly's oral GLP-1 nears a U.S. decision

Patients in the U.S. can now get a once-daily pill version of Wegovy, the first oral GLP-1 approved for obesity, and a rival pill from Eli Lilly is expected to win U.S. approval within months ^[1]. Coverage of the two launches describes 2026 as the year that oral GLP-1s test whether convenience and lower cash prices can widen the market beyond weekly injections ^[1].

What the pills cost

The Wegovy pill's cash price ranges from $149 to $299 per month depending on dose ^[1]. That is somewhat below the recently lowered cash prices of the injections: Novo Nordisk cut nearly all doses of Wegovy to $349 per month in November, and Eli Lilly said in December that the highest doses of single-dose Zepbound vials would cost $449 per month for cash-paying patients ^[1]. Eli Lilly's pill is expected to have pricing similar to Novo Nordisk's for cash-paying patients ^[1].

Through the TrumpRx direct-to-consumer site, the starting dose of both pills will be available for $149 per month under a November deal the two companies struck with the Trump administration ^[1]. People whose insurance covers the Wegovy pill may pay as little as $25 per month ^[1].

A different kind of patient

Doctors and analysts quoted in the coverage expect pills to draw people who have not tried GLP-1s, including those who dislike needles or who do not see their condition as severe enough for a weekly shot ^[1]. "I think that there are a lot of people out there who have never tried these GLP-1 drugs and are maybe waiting for the pills to come out," said Dr. Eduardo Grunvald, medical director of the UC San Diego Health Center for Advanced Weight Management ^[1]. Leerink Partners analyst David Risinger said pills could mainly attract patients who are overweight or mildly obese and want only "modest" weight loss ^[1].

Exactly how many people in the U.S. use GLP-1s is not precisely known; about 1 in 8 adults said they were taking one for weight loss or another chronic condition as of November, according to a KFF poll ^[1]. Goldman Sachs analysts forecast in August that pills could capture roughly 24% — about $22 billion — of the global weight-loss drug market by 2030, part of a market some analysts say could be worth almost $100 billion by the 2030s ^[1].

Injections are not going away

In separate late-stage trials, Zepbound has shown average weight loss of more than 20%, higher than results for the Wegovy injection, the Wegovy pill and Eli Lilly's oral drug ^[1]. In those studies, about 7% or fewer patients stopped treatment because of side effects from the Zepbound and Wegovy injections; the Wegovy pill had similar discontinuation rates, while about 10.3% of patients taking the highest dose of Eli Lilly's oral drug stopped because of side effects ^[1].

Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women's Hospital, said cost would be the only real reason to move a patient doing well on injections to a pill, and that she prefers injectables when cash prices are similar ^[1]. Risinger said patients who need to lose a larger share of body weight will likely stay on injections unless they fear needles ^[1].

The pills also differ in how they are taken. The Wegovy pill is a peptide medication, and patients are supposed to drink no more than four ounces of water with it and wait 30 minutes before eating or drinking anything else each day ^[1]. Eli Lilly's orforglipron is a small-molecule drug that is absorbed more easily and does not carry that dietary restriction ^[1].

Why it matters for patients

The pill adds a second route into treatment that does not require refrigeration or a weekly injection, which one patient said would make travel easier ^[1]. The cash price gap is modest — Grunvald said the roughly $150 monthly difference between the highest Zepbound dose and Novo Nordisk's pill "could be a big difference for many people" paying out of pocket ^[1].

Whether pills widen insurance coverage is a separate question. John Crable, senior vice president of the benefits brokerage Corporate Synergies, said direct-to-consumer cash prices for the oral drug are likely "significantly less" than what employers and pharmacy benefit managers would pay, and that some employers have dropped GLP-1 coverage for obesity in 2026 ^[1]. He said it is unclear how much the pill will ultimately cost payers, since those prices are not publicly disclosed ^[1].

Eli Lilly said in December that patients who started on Wegovy or Zepbound injections maintained the majority of their weight loss after switching to its pill ^[1].

What happens next

Eli Lilly's orforglipron is slated for a U.S. approval decision later in 2026, with Risinger expecting it to reach the market months after the Wegovy pill ^[1]. Real-world data comparing how pills perform against injections has not yet been reported ^[1].