For Novo Nordisk, the company’s long-awaited launch of Wigovy tablets earlier this year, the first oral GLP-1 for obesity, was an opportunity for Novo Nordisk to regain some of the chronic weight management market it had ceded to U.S. rival Eli Lilly.
Now, updating the rollout of oral semaglutide products to date, the range of popularity of the pill and its potential to reach new obese patients cannot be ruled out.
Since its Jan. 5 pill launch, which preceded Lilly’s launch of oral GLP-1 for Foundayo in early April, oral Wegoby has attracted more than 3 million prescriptions, making it “one of the strongest new U.S. drug launches in history,” according to a company press release, and coincided perfectly with Novo’s appearance at the American Diabetes Association 2026 Scientific Sessions in New Orleans over the weekend.
Put another way, 3 million prescriptions over about five months equates to one Wegovy pill script being filled “approximately every five seconds,” according to the company.
It didn’t take long for the pills to pick up steam. Novo noted that oral Wegovy reached its first 1 million prescriptions in the U.S. just 12 weeks after it arrived in pharmacies and online providers. The subsequent 2 million prescriptions were delivered even faster, in just 10 weeks, the company said.
Novo hoped that the introduction of an oral option for chronic weight management would make the drug accessible to patients who have not previously tried anti-obesity medications (AOMs), and also hoped that the new format would not cannibalize sales of injectable incretins. That theory appears to be borne out, as Novo announced on Sunday that more than 80% of new Wegovy pill prescriptions are being administered to new patients on GLP-1 therapy.
The company says that throughout 2026, more patients starting a new weight management therapy chose Wegovy over other AOMs. In addition, the Danish drugmaker touted the “powerful dose” of its recently launched 7.2 mg high-dose injection Wegovy.
Novo’s Wigovy tablet passed FDA review in late December, and the company launched the drug on the U.S. market two weeks later. The Wegovy tablet is a nod to weight management as well as a green light for reducing heart risks in people who are obese or overweight, reflecting one of the key indications for injectable tablets.
Novo appears to maintain an impressive lead, at least on a numerical basis, as analysts track the launches of both Wigovy tablets and Lilly’s Foundayo. Nevertheless, teams at shops like Jefferies and Citi say their analysis based on IQVIA’s prescription data may significantly underreport telemedicine referrals, thereby skewing the numbers.
Still, the momentum certainly marks a welcome role reversal for Novo Nordisk, after several years in which Lilly’s injectable bariatric drug Zepbound replaced the injectable Wegoby as the leading AOM in the United States.
play the long game
Ed Sinka, Novo Nordisk’s senior vice president of marketing and patient solutions, who oversees U.S. commercial strategy for the company’s cardiometabolic portfolio, said in an interview with Fierce during the ADA Scientific Sessions that Novo still has “a significant amount of time” before exclusivity on semaglutide is lost.
But as it stands, “we’ve only scratched the surface” of the overall uptake of the anti-obesity drug GLP-1, Shinka said.
“The unfortunate reality is that while approximately 120 million people in the United States are eligible for AOM, only a minority actually receive AOM therapy,” Shinka explained.
As for how Novo plans to continue reaching people who could benefit from obesity drugs, “It’s about meeting patients where they are,” Shinka said, adding, “Part of the barrier to drug receipt is cost and insurance coverage, and that’s a very real reality for patients and their families.”
Affordability and cash-paying patients were top priorities for Novo, which launched the drug earlier this year. With this rollout, the starting dose for the oral option will be 1.5 mg/month, set at $149 for self-pay patients, but can be as low as $25 per month for commercially insured patients with savings plans.
While Novo is working on a number of fronts to lower the cost and ensure broader application of incretins, “form factor” is also an important factor, and Shinka noted that having an effective obesity drug available in pill form is “essential” for Novo as it continues its efforts to expand its market.
Meanwhile, regarding Novo’s use of direct-to-patient (DTP) platforms, digital pharmacies and telemedicine providers, Shinka said there is a “mismatch” between the number of patients seeking treatment and the number of physicians seeking treatment. In addition to high demand outstripping the “supply of care,” the stigma against obesity from both patients and physicians further compounds the challenges in seeking and receiving treatment, Novo executives explained.
“Patients now have an outlet where they can get information, they can get the right answers, and ultimately they can get products through digital means. This has been an incredible opportunity for so many of our patients. And as you can see now, patients are increasingly turning to online channels, whether it’s some of our telemedicine partners or our own pharmacy, Novocare. This is really very empowering,” the executive explained.
Aside from its own online pharmacy offering, Novo is increasingly turning to virtual health companies like LifeMD, Ro, and former nemesis Hims & Hers to expand its range of treatments and cater to patients seeking a more consumer medicine approach to weight management.
Novo Nordisk also ranks among the major drug companies that have struck “most-favored-nation” pricing agreements with the White House, and last November it announced price cuts for Wegoby and diabetes company Ozempic for both Medicare and self-pay patients, and listed its drugs through the government’s online drug-purchasing portal TrumpRx.
Overall, Novo’s Wegovy tablets hit the market for $355 million in the first quarter.
This impressive early performance, combined with other gains over the same period, led Novo to adjust its guidance for 2026, now expecting sales to decline between 4% and 12% in that period, slightly lower than the 5% to 13% decline the company had expected in February.
