MW Taking the new Wegovy pill every day is really complicated. Will patients stick with it?
By Jaimy Lee
'It's not an easy pill to take': The first highly anticipated GLP-1 pill is here, but physicians aren't sure it has the staying power of the injections
Once you take the Wegovy pill in the morning, you have to wait 30 minutes before eating or drinking anything.
Patients are thrilled that there's finally a GLP-1 pill, but swallowing one is not as simple as it seems.
Taking Novo Nordisk's (NVO) Wegovy pill is an exacting process. You have to take it first thing in the morning, on an empty stomach, with no more than half a cup of water. Then you wait 30 minutes before eating breakfast, drinking coffee and other liquids, or taking other medications. You have to take the pill every day at the same time, and you must store it in the bottle (and not a pill box for travel).
"There's no other really big upside," said Diana Thiara, medical director of the University of California, San Francisco, Weight Management program. "Why would you do something that's marginally less effective and not actually that much easier?"
The prevailing idea has been that a pill is easier to take, it's cheaper and it doesn't require refrigeration like Wegovy and Eli Lilly's $(LLY)$ Zepbound injections. It's also been pitched as an alternative to people who say they don't want to use an injector pen or a needle.
But some physicians are skeptical that patients will stick with the Wegovy pill given the onerous daily regimen and comparable pricing to the Wegovy injection, especially if they end up not losing as much weight as they expect to. Instead of seeing a game-changer, these doctors view the Wegovy pill as another option in the toolbox that'll only work for certain patients.
"There's going to be a lot of patients that get a good benefit from it," said Scott Kahan, director of the National Center for Weight and Wellness in Chevy Chase, Md. "There's also going to be quite a lot of patients that end up not using it, or try it and find the administration to be somewhat difficult, but that's OK."
That said, the launch of the Wegovy pill is off to a roaring start. About 170,000 people in the U.S. had been prescribed the Wegovy pill by the first week in February, and "most" are paying directly for the medication, according to comments made by Novo's executives last week. Novo is charging $149 per month for the two lowest doses right now, and then the price goes up to $299 a month for the most effective doses. (The Wegovy injection costs $199 to start and then $349 to keep taking it.)
It's the first oral GLP-1 specifically approved for weight management. GLP-1 traditionally works best in an injection, but Novo Nordisk engineered the pill using technology that it acquired in 2020 to improve how well semaglutide - the medication's active ingredient - is absorbed.
"This is not just a pill," Novo CEO Mike Doustdar said last week during an earnings call. "It's a peptide. It's a large protein inside the pill that gives you that incredible efficacy."
Demand is huge, and so are the marketing budgets. Two Super Bowl ads mentioned the Wegovy pill. Wall Street has breathlessly tracked weekly the pill's prescription volume, and the early numbers briefly lifted Novo's long-struggling stock in January. One analyst described it as the "fastest launch ever." It's no wonder that Hims & Hers Health $(HIMS)$ rushed its own compounded version of the Wegovy pill to market before dropping those plans amid a legal dispute with Novo and U.S. regulators.
Novo is facing its own clock. Lilly is gearing up to launch a new non-peptide GLP-1 pill that won't have the same administration restrictions as the Wegovy pill. Lilly also said last week that it will have a "similar" entry price. The Food and Drug Administration is set to decide whether to approve Lilly's orforglipron by sometime this summer. Novo Nordisk did not immediately respond to a request for comment.
For now, patients are still trying to figure out if it's right for them. On Reddit, they are trading tips about how to handle the regimen, whether that's setting an early alarm, taking the pill, and going back to bed for 30 minutes, or asking how to relieve acid reflux from the pill if they do go back to bed.
"It's not an easy pill to take," said Scott Isaacs, an endocrinologist at Grady Memorial Hospital in Atlanta. "It's this regime that can be onerous, and then when people learn about that, they say, 'Well, maybe taking a shot once a week is easier.'"
Novo sells another semaglutide pill called Rybelsus that's approved to treat type 2 diabetes with similar requirements around administration. Some experts are now taking a second look at that data to better understand what adherence to the Wegovy pill could look like.
"I do know - from my experience prescribing Rybelsus, which is basically the same thing for diabetes - it's hard to get patients to stay on it," Isaacs said. "We see a lot of treatment failures, and when you assess why it's a treatment failure, most of the time it's because they're not taking the medication correctly."
There is some data to back that up. The pharmacy benefit manager Prime Therapeutics published a study in 2024 that found patients who did not have diabetes and started taking Rybelsus were far less adherent to the medication than those on Ozempic and Wegovy injections. (All three drugs are made with semaglutide as the main ingredient, though they are approved for different conditions and with different doses.)
The research compared adherence rates for people starting eight GLP-1s in 2021, though it doesn't reflect some of the broader market dynamics at play that year. Wegovy wasn't approved until the middle of 2021, and Novo was dealing with major supply issues by the end of that year.
In general, it can be harder for some patients to adhere to a daily pill rather than a weekly injection, experts say. Adherence rates are usually lower in real life than in the closely controlled environment of clinical trials. But some prefer a daily pill over a weekly injection.
"If people don't follow that very explicit requirement about how to take it, you will not get the extent of the drug absorption that you need to get the full effect," said Pat Gleason, Prime Therapeutics' assistant vice president of health outcomes. "You're going to end up having stayed on [the] drug for six months, but you aren't getting your 10% body weight loss that you were told you were likely to get."
The pill led to an average weight loss of 13.6% in clinical trials, while the Wegovy injection produced about 15% weight loss.
Physicians expect they will need to switch some patients on the pill over to the injectable so they can get the weight loss they're looking for.
"We would have no reason to say no," UCSF's Thiara said.
-Jaimy Lee
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(END) Dow Jones Newswires
February 10, 2026 15:48 ET (20:48 GMT)
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