Wegovy Pill Approved as GLP-1 Supply Eases and Pricing Shifts in 2026

The first oral formulation of semaglutide for weight loss, Novo Nordisk's Wegovy pill, received FDA approval in January 2026 and quickly reached more than 26,100 prescriptions in its second week of sales. The approval comes as GLP-1 supply shortages have largely been resolved, government-led pricing agreements have cut out-of-pocket costs for many patients, and new research has highlighted how quickly weight returns after stopping treatment.

Background

GLP-1 receptor agonists such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have moved from diabetes care into mainstream obesity treatment. Prescription volumes rose nearly 587 percent from 2019 to 2024, and by December 2025 these drugs accounted for more than 7 percent of all U.S. prescriptions. Severe shortages of semaglutide began in March 2022 and lasted until the FDA declared the shortage resolved in February 2025 after confirming that manufacturer supply could meet national demand. Tirzepatide supply also improved around the same time.

Key Details

In a 64-week trial, the Wegovy pill produced an average 14 percent weight loss versus 2.4 percent with placebo; 76 percent of treated adults lost 5 percent or more of body weight versus 31 percent with placebo. Eli Lilly's small-molecule oral GLP-1, orforglipron, is under expedited FDA review and could be approved in the second quarter of 2026, offering a non-injectable option with a different manufacturing profile. Next-generation combinations are advancing: Novo submitted CagriSema (semaglutide plus the amylin analogue cagrilintide) to the FDA in December 2025; in trials it achieved about 20 percent weight loss. Lilly's triple agonist retatrutide has shown roughly 24 percent weight loss in phase 2 studies, with phase 3 readouts expected in 2026.

Pricing has shifted sharply. List prices for Ozempic and Wegovy had exceeded $1,000 per month; under the Trump administration's Most Favored Nation agreements, prices through the TrumpRx marketplace fell to $350 per month for Ozempic and Wegovy, and Zepbound to an average of about $346. Medicare negotiated prices of $245 per month for major GLP-1s, with beneficiary copays of $50. Medicaid coverage for obesity remains optional; as of January 2026 only 13 state Medicaid programs covered GLP-1s for obesity, and several states had dropped or were considering dropping coverage due to cost. The CMS BALANCE model, launched to expand access in Medicaid and Medicare while controlling costs, is expected to start in Medicaid as early as May 2026.

A 2026 meta-analysis in The BMJ found that after stopping GLP-1s, participants regained weight about four times faster than after behavioral weight loss, with body weight returning toward baseline in roughly 1.7 years and cardiometabolic improvements fading in about 1.4 years. The authors noted that "these drugs alone may not be sufficient for long term weight control" and stressed the need for combined behavioral support and possibly indefinite treatment. Real-world data suggest about half of people discontinue GLP-1s within a year; many later restart, reflecting the chronic nature of obesity management.

Impact

Resolution of shortages has allowed volume-based growth for manufacturers while compounding pharmacies continue to serve price-sensitive patients—an estimated 1 million compounded prescriptions in early 2026—despite FDA enforcement against unapproved compounded GLP-1s marketed as equivalent to approved drugs. Cardiovascular evidence has expanded: a large trial in The Lancet reported that semaglutide cut major cardiovascular events by about 20 percent regardless of BMI or weight loss, with roughly two-thirds of the benefit unexplained by weight change alone, supporting a role for GLP-1s in cardiovascular risk reduction beyond obesity. Wegovy is approved for MASH (metabolic dysfunction-associated steatohepatitis) in certain adults with liver fibrosis.

What's Next

Oral options and next-generation agents will broaden access and efficacy. Regulatory scrutiny of compounded and direct-to-consumer GLP-1 claims will continue. Payers and clinicians will grapple with long-term use, combination with lifestyle intervention, and equity of access as the market fragments into branded, generic, and compounded tiers.