Novo Nordisk began selling its once-daily weight-loss pill in the United States on Monday, marking a significant development in the increasingly competitive pharmaceutical market for obesity treatments.
The Danish drugmaker is offering its Wegovy pill in four dosage levels, with the entry point set at $149 per month for self-paying patients. This pricing strategy represents a deliberate shift toward consumers who pay out of pocket rather than relying on insurance coverage, a departure from traditional pharmaceutical business models.
The Food and Drug Administration approved the medication last month, providing Novo Nordisk with a crucial tool as it works to recover market position lost to American competitor Eli Lilly. The timing proves particularly important for the Danish company, which experienced profit warnings and declining share values last year.
The pill contains semaglutide, the same active ingredient found in Novo Nordisk’s injectable weight-loss and diabetes treatments sold under the brand names Wegovy and Ozempic. The company is offering starter doses of 1.5 milligrams and 4 milligrams initially, with higher doses of 9 milligrams and 25 milligrams becoming available by week’s end. The two higher doses carry a price tag of $299 monthly, while the 4-milligram dose will increase to $199 beginning April 15.
The medication will be distributed through major pharmacy chains CVS and Costco, as well as through telehealth providers including Ro, LifeMD, WeightWatchers, GoodRx, and Novo Nordisk’s own NovoCare Pharmacy. The market responded favorably, with Danish-listed shares of Novo Nordisk closing 5 percent higher Monday, while American-listed shares rose 4.6 percent. Eli Lilly shares declined 3.5 percent in afternoon trading.
The appeal of a daily pill extends beyond simple convenience. For patients who find injectable medications unpleasant or impractical, the oral alternative offers meaningful flexibility. The treatment is currently under review by international regulators, with a decision expected from British authorities by year’s end.
Eli Lilly remains a formidable competitor in this space. The company expects regulatory approval for its own weight-loss pill in March and has announced plans to cap higher doses at $399 monthly for repeat cash buyers. Lilly’s injectable drug Zepbound has maintained an advantage over Wegovy in weekly American prescriptions throughout the past year.
The pricing landscape for these medications reveals the complexity of the modern pharmaceutical market. Injectable versions of these treatments typically carry list prices exceeding $1,000 monthly. Both Novo Nordisk and Eli Lilly have reduced prices for cash-paying customers, with Novo Nordisk offering its Wegovy injection at $349 monthly since November.
An agreement with President Donald Trump adds another dimension to market access. Both companies committed to providing starter doses of their weight-loss pills at $149 monthly for Medicare and Medicaid enrollees, as well as cash payers through the White House’s new direct-to-consumer TrumpRx site.
The success of these oral medications will largely depend on their ability to attract consumers who lack insurance coverage for weight-loss treatments. This represents a fundamental change in how pharmaceutical companies approach the obesity treatment market, shifting focus from insurance-negotiated pricing to direct consumer sales.
As the competition between these pharmaceutical giants intensifies, American consumers stand to benefit from increased options and more accessible pricing in the treatment of obesity, a condition affecting millions of Americans.
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