The cost of weight-loss drugs should fall in 2026

The blockbuster weight loss drug semaglutide and its competitors promise to help reverse the global trend. obesity epidemics—if only more people who could afford these treatments could afford them. But this year we can see long-awaited steps in this direction.

Losing weight for years drugs were in short supply, but by the end of 2024, manufacturers caught up with the huge demand. But drugs like semaglutide (sold under the brand names Wegovy or Ozempic) remain very expensive, typically requiring several thousand dollars in annual supplies.

This price puts them out of reach for most of the more than 1 billion obese people worldwide; only 3 percent of eligible people in the US take weight loss medications, and less than 1 percent in other countries, according to financial company Morgan Stanley.

But two key events are expected in 2026. approval of a drug called orforglipron in various countries. It works in the same way as semaglutide, mimicking the action of the hormone GLP-1, which reduces appetite. But it is a small molecule, meaning that, unlike semaglutide, it can be absorbed through the intestines and can therefore be taken in tablet form.

“Pills are cheaper to produce, easier to store and easier to distribute,” says Laura Heisler at the University of Aberdeen in the UK. “In short, the pill could provide treatment to more people who need it.”

Semaglutide, on the other hand, is a large molecule, a kind of protein. The production of large-molecule drugs is usually much more complex and expensive. They also usually have to be injected, and delivering them in pens increases costs and complications. These are the reasons why manufacturers struggled for a long time to meet the demand for GLP-1 drugs after they became popular. weight loss.

Oddly enough, there is a tablet form of semaglutide called Rybelsus that is approved for type 2 patients. diabetesand semaglutide manufacturer Novo Nordisk has applied for approval of a form of diet pill.

However, Ribelsus is not an ordinary pill. It contains semaglutide in combination with a substance called sodium salcaprosate, which neutralizes stomach acid and “liquefies” cell membranesallowing semaglutide to pass through the cells lining the intestines and into the bloodstream. You don't want this to happen with partially digested food, so Ribelsus should be taken at least 8 hours after eating, and people should not eat or drink for half an hour after taking it.

All this explains why orforgliprone should be cheaper to produce than semaglutide, and why it can be taken without special requirements for Ribelsus.

The approval of another GLP-1 drug will also increase competition among pharmaceutical companies. The manufacturer of orforgliprone, Lilly, has not yet announced prices, but has already indicated that it would be cheaper than other GLP-1 drugs.

The only downside is that it seems to be less effective: people receiving the highest dose lose about 10 percent of their weight after 72 weekscompared to about 14 percent for semaglutidealthough it would require an in-person trial to confirm this.

The second important development is the expiration of patents on semaglutide in countries such as China, India, Brazil, Canada and Türkiye, i.e. for a large part of the world's population. This means drug makers may start selling generics.

Generics must be approved and meet the same standards as proprietary versions, but can be much cheaper. “When a drug loses patent protection, generic competition typically drives prices down by as much as 90 percent,” says Jeremy Durrant at Medicines UK, the generic medicines industry association.

Soon many more people will be able to access these medicines. But in guidelines published in December, the World Health Organization (WHO) recommended that people receive advice on behavior and lifestyle changes, in addition to medications, to maximize benefits and ensure they are maintained. “Medicines alone cannot address the global burden of obesity,” they wrote. Francesca Celletti to WHO.