Novo Nordisk is ready for another round of the weight-loss-drug wars

Nearly two years after the launch of Lilly’s injectable Zepbound, and four years after the launch of Novo’s injectable Wegovy, investor attention is shifting to weight-loss pills. They are expected to hit the market next year.

Lilly’s orforglipron has received the most attention. But Novo’s oral semaglutide, or what it calls Wegovy-in-a-pill, will likely reach the market first, and it looks like it works surprisingly well.

Today, Lilly is the undisputed champion of the weight-loss business. Despite a multiyear head start, Novo has struggled with shortages of its shots and competition from compounding pharmacies. Lilly now has a bigger share of the U.S. GLP-1 market.

Novo shares are down nearly 60% since July 2024.

The anticipated launch of Wegovy-in-a-pill could offer Novo a shot at changing the narrative. The Food and Drug Administration is expected to issue a decision on Novo’s application by the end of the year, and a launch could come early next year.

On Friday, Barron’s spoke with Dave Moore, Novo’s executive vice president of U.S. operations, about Wegovy-in-a-pill. An edited version of the conversation follows.

Barron’s: Novo has had positive data on oral semaglutide as a weight-loss treatment for years, but hasn’t moved quickly toward launch. Why bring it to market now?

Moore: We had to make sure we were prepared and build supply resilience, so that we could bring Wegovy-in-a-pill forward in the U.S., and we wanted to make sure we had an unconstrained launch. We’re really excited about the potential to have the first oral GLP-1 for obesity.

How much active ingredient, or API, is required for a dose of injectable Wegovy, compared with a dose of the pill version? How do you know you’ll have enough?

The pill requires much more API than the injection. We’ve been building that supply, that readiness for launch, for a long time. The good news, too, is oral Wegovy is made end-to-end in the U.S., in North Carolina, in a plant that we built there.

Patients lose more weight on the injections, so what’s the market for a weight-loss pill?

Absolutely there will be people who are still interested in a once-weekly injection. What’s interesting now, though, is if you look at the results in our clinical trials, you’re getting close to injectable-like efficacy in a once-daily pill. And there will be people who are interested in that.

We know there are people that would be motivated to seek treatment if there was a pill available. And that is really what the potential is here, is that there’s a market expansion opportunity for those patients living with obesity that are not seeking treatment today.

As you said, Wegovy-in-a-pill requires a large amount of API. What does that mean for pricing? How will you be able to price the drug relative to Wegovy, and to Lilly’s orforglipron?

It’s a little early for us to comment on any real specific pricing strategies, and certainly I don’t know the plans for any other companies. What I can tell you is we’re not planning to price the Wegovy pill more than injection.

One idea on Wall Street is that the weight-loss pills will largely be sold through direct-to-consumer platforms to cash-paying customers. What are your plans?

It’s not on the market yet, and you never know until you see real-world practice. What I will say is the growing awareness on the consumer side, and the interest in being able to access medicines directly, is real in obesity. We are going to lean into that, we are not going to ignore it. Our plan is to have this available wherever patients are seeking care.

Novo shares have fallen a lot over the past year. How do you want investors to be thinking about Novo now?

The story about Novo is about growth, and about [the] long term. There is room for growth in diabetes, in obesity, in some of the related conditions. If you think about obesity, we are really just getting started. We are the pioneers, we are the leader globally in terms of GLP-1 distribution, and we’ve been innovating. We’ve been in this class for 25 years, and there’s more coming in our pipeline.