No More Needles? Novo’s Oral Weight-Loss Pill Matches Wegovy Injection for the First Time

TradingKey - For years, injectable weight-loss drugs have dominated due to superior efficacy, but patients and physicians alike have long awaited a more convenient, cost-effective alternative: oral medications. 

Now, Novo Nordisk has released data showing its Wegovy pill achieves weight loss on par with the injection for the first time. Meanwhile, Eli Lilly’s orforglipron, an oral GLP-1 tablet, is expected to gain approval by year-end and launch in 2026 — signaling a potential end to the “injection era” of obesity treatment.

Danish pharmaceutical giant Novo Nordisk (NVO) recently unveiled results from a 64-week Phase III trial, showing that patients taking the oral version of Wegovy lost 16.6% of their body weight, nearly matching the 17% weight loss seen in recent studies using the injectable form.

“It was the first time that an oral and injectable weight-loss drug had been more or less at par,” said Ludovic Helfgott, Executive Vice President for Products and Portfolio at Novo.

For years, injectable GLP-1 drugs from Novo Nordisk and Eli Lilly have taken the world by storm, sending both companies’ stocks soaring — with Novo briefly becoming Europe’s most valuable company and Lilly remaining among the top 15 U.S. stocks by market cap.

Injectable treatments typically deliver 15–24% weight loss, outperforming earlier oral options that achieved only over 10%. However, high costs (from manufacturing and cold-chain logistics), the need for injections, and concerns about patient adherence have kept some users on the sidelines. As such, injectables may remain best suited for patients needing maximum efficacy.

For broader populations, oral pills offer greater convenience and accessibility. But oral formulations face challenges: poor absorption, inconsistent drug concentration, and gastrointestinal side effects. 

The active ingredient in these tablets — semaglutide — is a peptide that is largely broken down in the gut before it can enter the bloodstream, unlike injections which deliver stable, predictable dosing.

Novo Nordisk says it has overcome this hurdle by adding a special compound to its pill that enhances gastric absorption.

Helfgott said Novo was increasingly convinced of the importance of an oral to offer patients another way to take weight-loss drugs.

“A few years ago, it was deemed impossible to put a peptide in a pill.”

Lilly’s Oral Drug Set to Monetize

Coincidentally, Eli Lilly’s oral candidate orforglipron has also made significant progress. According to a recent medical journal publication, patients taking 36 mg of orforglipron achieved an average 11.2% weight loss over 72 weeks. More than half lost at least 10%, 36% lost over 15%, and 18.4% lost more than 20%.

While average weight loss lags behind Novo’s latest results, many doctors note that side effect profiles are similar to injectables. An oral option will likely expand treatment access, as it’s easier to produce, simpler to use, and potentially cheaper.

One medical professor stated that achieving over 10% weight loss in pill form is already clinically meaningful — it will carve out a solid place in the market.

Wall Street expects orforglipron to gain FDA approval by year-end, with a 2026 commercial launch, thanks to the Trump administration’s push for lower drug prices and the FDA’s new accelerated review program (one to two months).

Citi said the new FDA initiative is a perfect match for Lilly’s oral weight-loss strategy. Goldman Sachs estimates that if orforglipron launches a quarter earlier than expected, it could generate $1 billion in revenue for Lilly.

Can Novo Regain the Lead?

Often dubbed the “duopoly of weight-loss drugs,” Novo and Lilly are seeing diverging stock performances. Due to sluggish U.S. sales, rising competition from Lilly and generic manufacturers, and concerns over its next-generation pipeline, Novo’s stock has fallen over 33% in 2025, while Lilly is down just over 2%.

In August, after reporting Q2 earnings, Novo slashed its full-year guidance:

• Net sales growth revised from 13–21% to 8–14%
• Operating profit growth cut from 16–24% to 10–16%

With its oral Wegovy now showing comparable efficacy and a favorable side-effect profile, Novo is betting heavily on the pill to reshape the competitive landscape.

The company emphasized that both the pill and injection contain the same active ingredient, and regulators and doctors will recognize their broad health benefits. Injectable Wegovy has been proven to significantly reduce major cardiovascular events, and semaglutide itself is recognized for its cardioprotective effects.