The blockbuster weight loss drug semaglutide, along with competitors, offers potential solutions to the global obesity crisis. However, access remains limited for many who could greatly benefit from these innovations, though changes are on the horizon.

Historically, weight loss drugs have been scarce; yet, by the end of 2024, manufacturers are expected to meet the skyrocketing demand. Nevertheless, treatments like semaglutide (marketed as Wegovy or Ozempic) continue to carry hefty price tags, often reaching thousands of dollars annually.

This pricing structures keeps these essential medications out of reach for the over 1 billion individuals affected by obesity globally. In the U.S., a mere 3 percent of the population utilizes weight-loss medications, with the numbers dipping below 1 percent in other countries, according to Morgan Stanley.

Looking ahead, 2026 promises significant developments, including the approval of orforglipron in multiple countries. This new medication mimics the GLP-1 hormone, known for its appetite-reducing properties. Unlike semaglutide, orforglipron, as a small molecule, offers tablet-based administration.

“Tablets are inexpensive to produce, simple to store, and easy to distribute,” explains Dr. Laura Heisler from the University of Aberdeen, UK. “In essence, the medication can reach a broader audience in need.”

In contrast, semaglutide is a larger molecule and a type of protein. Polymer drugs like these are generally challenging and costly to produce. They often require injections, complicating their supply and driving up costs. This has been a significant barrier to fulfilling the demand for GLP-1 drugs.

It’s important to note that there is a semaglutide version in pill form, Rybelsus, approved for type 2 diabetes. Novo Nordisk, the manufacturer, has also sought approval for a weight loss variant.

However, Rybelsus isn’t just any medication; it includes semaglutide alongside sulcaprosate sodium, which neutralizes stomach acid to facilitate absorption into the bloodstream. To maximize effectiveness, it must be taken at least 8 hours post-meal, with no food or drink for 30 minutes.

This complexity is part of the reason orforglipron has a lower production cost compared to semaglutide—it can be taken without the stringent requirements of medications like Rybelsus.

Furthermore, the introduction of orforglipron will foster competition among pharmaceutical companies. While Lilly, the producer of Orforglipron, has yet to disclose pricing, it has been shown to be less costly than other GLP-1 alternatives.

The sole drawback is that orforglipron appears less effective; those on the highest doses typically lose about 10% of body weight over 72 weeks, compared to 14% with semaglutide. Further research is needed to validate these findings.

Another critical development is the anticipated expiration of semaglutide patents in nations such as China, India, Brazil, Canada, and Turkey—home to a significant population. This could pave the way for generic versions to enter the market.

Although generics must meet the same standards as their branded counterparts, they often come at a fraction of the cost. “Once a drug loses patent protection, generic competition usually leads to price reductions of up to 90%,” states Jeremy Durant of Medicines UK, the association for generic drug manufacturers.

This shift may expand access to these crucial treatments. That said, the World Health Organization (WHO) recently advised that patients should also receive counseling about behavioral modifications and lifestyle changes to maximize the efficacy of medications. “Drugs alone won’t address the global obesity crisis,” says Francesca Ceretti of WHO.