AYESHA RASCOE, HOST:
Drugs like Wegovy and Ozempic have become increasingly popular options for millions of people who want to reach a healthier weight. But the drugs, taken as weekly injections, aren't for everybody or every wallet. That's why experimental pills that could do the same thing are drawing so much attention. A Wegovy-style pill is expected to win approval from the Food and Drug Administration by the end of the year. NPR pharmaceuticals correspondent Sydney Lupkin is here to talk with us about that possibility. Good to have you here, Sydney.
SYDNEY LUPKIN, BYLINE: Thanks for having me.
RASCOE: Why hasn't there been a pill version of these drugs until now? I mean, it seems like something a lot of people would want.
LUPKIN: Yeah. I mean, it's a good question. And there sort of is. It's called Rybelsus, but it's only approved for Type 2 diabetes. It's made by Novo Nordisk, which is the same company that makes Ozempic for Type 2 diabetes and Wegovy for obesity. But it's a lower dose of the active ingredient these injectable drugs share - semaglutide. The new pill would be a higher dose aimed at patients with obesity, and studies show its efficacy is pretty close to Wegovy's. Tracy Zvenyach is the director of policy strategy and alliances at the nonprofit Obesity Action Coalition. She says more options would be a big deal.
TRACY ZVENYACH: The patient community in the obesity space has been living without - gone without treatment for so long. So new innovations, new treatments to treat this chronic disease - all are welcome. All are exciting.
LUPKIN: She says a lot of patients are hopeful about the new pills, particularly if they've had a hard time accessing the injections for one reason or another.
RASCOE: OK. So how would this new pill work? Is it the same as the injectable versions?
LUPKIN: So semaglutide, that active ingredient, gets broken down pretty quickly in the stomach - too quickly to actually get absorbed and do its job. That's why it's mostly been an injectable. So Novo Nordisk added something to it to fix that. It's a chemical with a long name, but the abbreviation is S-N-A-C - SNAC. Andrea Traina, one of Novo Nordisk's obesity directors, explained how it works.
ANDREA TRAINA: If you think about dropping an Alka-Seltzer tablet in a glass of water, that immediate fizzy reaction that occurs - that is what happens in your stomach as soon as this tablet hits the base of your stomach, hits that stomach wall.
LUPKIN: It creates this fizzy environment just around the pill, blocking the stomach acids from breaking it down too quickly and giving it enough time to get absorbed into the bloodstream. It takes about 30 minutes. So the pill needs to be taken on an empty stomach, and you can't eat or take other medications until it's absorbed.
RASCOE: OK. It seems like that might turn at least some people off. What have you heard from patients?
LUPKIN: Yeah. Well, there are other popular drugs that people already take that need to be taken the same way, so it's not a deal breaker for everyone. But not everyone is interested. If the injections are already working well for them, this would be a daily pill. The injections are weekly. But the big hope from patients is that this pill will be cheaper and get better insurance coverage than the injections. One person told me they just hope it's less expensive than their mortgage.
Dr. Richard Siegel is an endocrinologist at Tufts Medical Center.
RICHARD SIEGEL: But one of the big problems with all of the medicines in this arena has been the cost, and can we equitably get these medicines to the thousands - you know, millions, really - of people who might benefit from them?
LUPKIN: He says three-quarters of the messages he gets from patients are about these drugs, and a lot of them are dealing with renewals and insurance companies. His office is staffed to handle that, but not every doctor's office is. When some people lose insurance coverage, they can afford a few hundred dollars a month to buy directly from the drug manufacturers. But a lot of people can't, even with recent company discounts that make it as low as $200 a month in some cases.
RASCOE: So do you think the pills actually will be cheaper?
LUPKIN: So I don't know for sure, but pills typically are cheaper to make than drugs given by injection. The injector pens can also add to the cost. As for Novo Nordisk, it hasn't announced its sticker price yet. However, as part of a deal with the Trump administration, it said that for patients not using their insurance, they'd offer it for $149 a month. That's a cheaper direct-to-consumer price than for injectables, so it could be an encouraging sign. The company says access is an issue that it's working on with other parts of the drug supply chain.
RASCOE: That was NPR pharmaceuticals correspondent Sydney Lupkin. Thank you so much, Sydney.
LUPKIN: You bet. Transcript provided by NPR, Copyright NPR.
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