Lower-priced oral obesity drugs from Novo Nordisk and Eli Lilly are driving patients away from compounded GLP-1 medications, according to nine U.S. doctors interviewed by Reuters.

What is driving patients away from compounded drugs?

According to Reuters, during interviews doctors said that lower-cost introductory doses of Novo’s oral Wegovy and Lilly’s Foundayo are attracting patients who previously relied on compounded versions of GLP-1 therapies, particularly as insurance coverage for obesity treatments remains inconsistent.¹ Pricing for the oral products now closely matches the compounded alternatives while still offering patients access to FDA-approved branded therapies.

“I am seeing people are switching from compounds,” said Dr. Michael Weintraub, assistant clinical professor of endocrinology at NYU Langone. “I have patients increasingly coming to me saying, ‘I hear it’s not as expensive to get the pharmaceutical-grade branded version, can we switch over?’”

The transition could prove to be a strategic win for both Novo and Lilly, who both have pushed to steer patients toward branded products following previous widespread compounding activity. FDA has since moved to tighten oversight around compounded obesity medication, including taking action against mass-marketing of illegal copycat drugs.

Novo launched oral Wegovy in the U.S. in January, while Lilly introduced Foundayo in April. Both companies have reported strong initial demand, including Lilly reporting over 1000 Foundayo prescriptions within the first days on the market, particularly among patients new to GLP-1 therapy.¹

What are the prices?

The oral products are priced significantly below injectable versions for self-pay patients, with lower doses of oral Wegovy costing approximately $149 per month, compared with roughly $199 for injectable Wegovy pens. Foundayo also starts at around $149 monthly, while Lilly’s injectable Zepbound can cost $299 or more.

Back in February this year, Novo announced significant price drops on all its popular GLP-1 medications, including price reductions on its 25 mg Wegovy tablets and its 7 to 14 mg Rybelsus tablets.²

According to Reuters, doctors said oral formulations are helping expand access to obesity treatment among patients who previously declined GLP-1 therapies because of cost or reluctance to use injections.

“This is expanding the market of GLP-1,” said Sarah Ro, medical director of the University of North Carolina Health’s weight-management program. “Patients who have been offered a GLP-1, but due to price, declined... now, they’re wanting to try.”

Similarly, in a conversation with Pharmaceutical Executive, Madeline Verbeke, Senior Clinical Advisor, MMIT, mentioned the potential impact oral GLP-1 products could have on patient access, saying, “I think having the oral options, we could attract a lot of new patients to this space. We have patients who have that fear or aversion to needles, and this kind of opens up the door for them, and then, even in patients without the needle phobia, the convenience of an oral option will be appealing.”

Do patients have a preference between Foundayo or Wegovy?

Novo Nordisk appears to hold an early advantage in physician familiarity and patient confidence due to oral Wegovy useing the same active ingredient and branding as the company’s injectable product.¹ According to Reuters, doctors also pointed to existing cardiovascular outcomes data supporting Wegovy, which could influence prescribing decisions for patients at elevated cardiovascular risk.¹

By contrast, some physicians said patients remain cautious about Foundayo, Lilly’s newer oral therapy, which currently lacks long-term cardiovascular outcomes data.

“Something about saying it is new creates a little hesitation,” said Dr. Jorge Moreno, a Yale Medicine obesity specialist. “It’s a small sample, but they’ve opted for the Wegovy pill.”

Clinical trial data have also helped shaped perceptions, as oral Wegovy demonstrated approximately 14% weight reduction over 64 weeks in studies, while Foundayo showed roughly 11% weight loss over 72 weeks.¹ Injectable GLP-1 therapies have generally produced 15% to 20% weight reductions in pivotal trials.

Despite the trial data, physicians still expect the competitive dynamics to evolve. Foundayo’s dosing convenience, which doesn’t require fasting before administration, unlike oral Wegovy, could help Lilly gain share over time.¹ Citi analysts cited physician surveys suggesting the market could eventually split evenly between the two oral therapies, with some academic prescribers favoring Foundayo because of its simpler administration, according to Reuters.²

Despite growing enthusiasm around oral GLP-1 therapies, reimbursement remains a major obstacle, as the nine doctors interviewed by Reuters said insurance denials continue to limit patient access, particularly for obesity treatment categorized as preventive care.¹

“Every day, I get a message from a patient saying ‘my insurance company didn’t approve or denied it again,’” Moreno said.

Sources

1. Lower cost Novo, Lilly weight-loss pills draw patients from compounded drugs, doctors say Reuters May 21, 2026 https://www.reuters.com/legal/litigation/lower-cost-novo-lilly-weight-loss-pills-draw-patients-compounded-drugs-doctors-2026-05-21/
2. Novo Nordisk announces significant reduction in US list price for Wegovy®, Ozempic®, and Rybelsus® (semaglutide medicines), building on continued efforts to expand access Novo Nordisk February 24, 2026 https://www.prnewswire.com/news-releases/novo-nordisk-announces-significant-reduction-in-us-list-price-for-wegovy-ozempic-and-rybelsus-semaglutide-medicines-building-on-continued-efforts-to-expand-access-302695705.html