Short Wave Podcast Summary

Episode Title: GLP-1 Pills Are On The Way. Here’s What To Know
Hosts: Emily Kwong & Regina Barber (featuring Sidney Lupkin)
Date: December 19, 2025
Duration: ~15 minutes

Main Theme

This episode explores the next chapter in weight loss drugs: the transition of GLP-1 medications from injectables to pills. Pharmaceutical correspondent Sidney Lupkin discusses the science behind GLP-1 drugs, the challenges of creating an oral version, the two leading new pills heading to market, and what the shift could mean for cost and access to obesity therapies.

Key Discussion Points & Insights

1. The Rise of GLP-1 Injectables

• Origin Story: The popularity of GLP-1 injectables started with “celebrity weight loss” and public revelations about drugs like Ozempic and Wegovy.
  • “It all started with celebrity weight loss... then it wasn't a secret anymore.” — Sidney Lupkin (00:36)
• How They Work: GLP-1s are hormones your body makes that trigger feelings of fullness after eating, but they act quickly and wear off fast.
  • The medication versions (e.g., Semaglutide in Ozempic and Wegovy) are modified to last much longer in the body—up to a week, explaining the weekly injections.
    • “Semaglutide actually has a half-life of a week instead of just two minutes.” — Andrea Treina, Novo Nordisk (05:17)
• Commitment and Cost: Weekly injections are a significant commitment and expensive—over $1,000/month—making insurance coverage tricky and often limited.
  • “They're not for everyone, or for every wallet.” — Sidney Lupkin (01:50)

Timestamp: 00:19 – 02:30

2. New GLP-1 Pills: How Do They Work?

• Medical Science Deep Dive: Andrea Treina (Novo Nordisk) gives a “Ms. Frizzle” (Magic School Bus-style) explanation of the GLP-1 pill science.
• The Challenge: Proteins (like the active ingredient in these drugs) usually get broken down in the stomach before they can work as a pill.
  • “For 100 years, we've been trying to make a protein, a peptide-based molecule able to be absorbed orally.” — Andrea Treina (06:49)

Novo Nordisk's Pill – Semaglutide + “SNAC”

• Solution: The “SNAC” additive protects the drug in the stomach, creating a little local environment (like “dropping an Alka Seltzer in water”) that helps the peptide get absorbed before being destroyed.
  • “When you swallow that tablet, it creates a tiny little micro environment at the base of the stomach... like dropping an Alka Seltzer.” — Andrea Treina (07:57)
• Restriction: The pill must be taken on an empty stomach and you must wait 30 minutes to eat after.
  • “The catch is that you have to take this pill on an empty stomach and wait 30 minutes before eating anything else for it to work.” — Sidney Lupkin (08:26)
• Not for Everyone: Some patients are happy sticking with injections – but for many, a pill is an exciting alternative.

Timestamp: 03:52 – 08:55

Eli Lilly's Pill – Orforglipron

• New Compound: Different from their injectable (tirzepatide); this new oral drug isn't a peptide, so doesn’t have the same absorption restrictions.
  • “Eli Lilly isn’t saying in detail yet, but... it is not a peptide. So it doesn’t have the same restrictions around when you need to take it.” — Sidney Lupkin (09:25)
• Clinical Trials: Dr. Max Denning (Eli Lilly) explains the rigorous double-blind process; notes how long and massive these studies are to prove safety/effectiveness.
  • “You need a huge number of doctors, ... a huge number of sites to be participating in clinical trials... that whole process takes maybe two, two and a half years.” — Dr. Max Denning (09:58, 10:29)
• Results: Orforglipron showed ~12% weight loss at the highest dose over 72 weeks; also effective at lowering blood sugar (A1C).

Timestamp: 08:55 – 11:23

3. Comparing Pills: Efficacy & Practicality

• Novo Nordisk’s Pill: Study showed ~16-17% weight loss over 64 weeks with the 25mg semaglutide pill—comparable to injectable Wegovy.
  • “Novo Nordisk may have a bit of an edge here.” — Sidney Lupkin (11:27)
• Eli Lilly’s Pill: Slightly lower efficacy (~12% at max dose), but a different dosing experience.
• Patient Perspectives: Some prefer injections; others excited for the convenience of a pill. Ultimately, more options mean broader accessibility.

Timestamp: 11:23 – 12:08

4. Cost & Access: Will Pills Be Cheaper?

• Uncertain Pricing: Official sticker prices not announced by Novo Nordisk or Eli Lilly.
• Hope for Affordability: Pills are cheaper to manufacture than injectables, possibly leading to lower costs.
• Early Deals: Pills could be available for $149/month out-of-pocket (without insurance), per a notable deal this year.
  • “That is not a sticker price, but it could mean that a lower sticker price is coming... more people able to get their hands on these if they need them.” — Sidney Lupkin (12:55)

Timestamp: 12:08 – 13:08

Notable Quotes & Memorable Moments

• “Think about how your stomach breaks down some chicken that you’ve eaten... our body is trained to... attack those proteins almost immediately.” — Andrea Treina (06:49)
• “It creates a tiny little micro environment at the base of the stomach right where that tablet sits... like dropping an Alka Seltzer tablet in a glass of water.” — Andrea Treina (07:57)
• “The anticipation coming up to that first moment when the data card flips over and you see: does this medicine work?” — Dr. Max Denning (10:29)
• Host banter about “Ms. Frizzle” and creative science explanations keeps the tone friendly and accessible.

Important Timestamps

• 00:19 – 02:30: Introduction to GLP-1 injectables, public interest, and the promise of oral alternatives.
• 03:52 – 08:55: Science behind GLP-1s, explanation of pill design and challenges.
• 08:55 – 11:23: Eli Lilly’s alternative, clinical trial process, and outcomes.
• 11:23 – 13:08: Comparing efficacy, patient preferences, and cost considerations.

Conclusion

This episode paints a hopeful picture of the next phase of weight loss medication, with major breakthroughs bringing pill formulations to market. This could democratize access thanks to easier dosing and potentially lower prices, all while maintaining or even improving the efficacy currently seen with injections. As the science and pharmaceutical landscape shifts, patients and clinicians will have more choices than ever for obesity therapy.

For listeners wanting the essential points:

• GLP-1 weight loss drugs are moving from injectables to convenient, potentially less costly pills.
• Two types are on the horizon: a semaglutide pill by Novo Nordisk (requiring specific timing), and a new compound pill by Eli Lilly (more flexible).
• Pills may match injectables’ effectiveness, and deals suggest future affordability and wider access.

Episode hosted by Emily Kwong & Sidney Lupkin, produced by the Short Wave team at NPR.