GLP-1 Pills Are On The Way. Here's What To Know

Summary

---

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.

Transcript

[Capital One / LinkedIn / Indeed / Vanta / BetterHelp / Shopify Announcer]

This message comes from Capital One. Say hello to stress free subscription management. Easily track block or cancel recurring charges right from the Capital One mobile app. Simple as that. Learn [e-mail] Subscriptions Terms and Conditions apply.

[Emily Kwong]

You're listening to Short Wave from npr. Hey, short waivers. I am here with NPR pharmaceuticals correspondent Sidney Lupkin today to talk about something that has really changed the game when it comes to weight loss, which is injections. When did this all start?

[Sidney Lupkin]

I mean, it all started with celebrity weight loss.

[Emily Kwong]

One hot topic everyone in Hollywood still seems to be talking about is Ozempic.

[Andrea Treina]

You're on Ozempic or one of those things or Wegovy or whatever or you got work done. Like just, just stop.

[Sidney Lupkin]

Then it wasn't a secret anymore.

[Emily Kwong]

Yeah, I remember even Serena Williams came forward as like a spokesperson for the telehealth company. Rose GLP1 injections. I knew my body was missing something it needed.

[Sidney Lupkin]

For me, the answer was GLP1s. Now these weight loss injections called GLP1s are kind of everywhere. Examples include Ozempic, which is kind of the Kleenex of GLP1 drugs but is actually officially for type 2 diabetes, and WeGovy. These are drugs you inject under the skin once a week. And these injectable drugs have become a valuable tool for millions of people trying to get to a healthier weight. We're talking people who've never been able to lose weight and keep it off, finally finding something that works for them.

[Emily Kwong]

These are clearly life changing medications and also it seems a big commitment. I mean, not everyone is going to want to inject something weekly for weight loss for sure.

[Sidney Lupkin]

And you know, they're not for everyone or for every wallet. Injectables do have a sticker price of over $1,000 a month and insurance coverage has been tricky to navigate for a lot of. So there's a lot of excitement around a new pill form of the drug. We're going to talk about two types of these pills. The first is a WeGovy pill that's expected to win FDA approval by the end of the year. And then there's another kind of obesity pill that could be right behind it.

[Emily Kwong]

Today on the show, a new era of weight loss medications. We talk about the science behind the.

[Sidney Lupkin]

Experimental pills and what FDA approval would mean for affordability and access.

[Emily Kwong]

You're listening to Short Wave, the science podcast from npr.

[Capital One / LinkedIn / Indeed / Vanta / BetterHelp / Shopify Announcer]

This message comes from LinkedIn ads. One of the hardest parts about B2B marketing is reaching the right audience. That's why you need LinkedIn ads. You can target your buyers by job title, company role, seniority and skills. All the professionals you need to reach in one place. Get a $250 credit on your next campaign so you can try it yourself. Just go to LinkedIn.com nprpod that's LinkedIn.com nprpod Terms and conditions apply. Only on LinkedIn ads. Support for this podcast and the following message come from Indeed. Spend more time interviewing candidates who check all your boxes with Indeed Sponsored jobs. Claim your $75 sponsored job credit now at indeed.comshortwave. terms and conditions apply. This message comes from Capital One. Say hello to stress free subscription management. Easily track block or cancel recurring charges right from the Capital One mobile app. Simple as that. Learn [e-mail] Subscriptions Terms and Conditions apply.

[Emily Kwong]

Okay Sunny, I want to talk about GLP1s. Am I saying that right? GLP1 GLP1s. How do they work?

[Sidney Lupkin]

So yeah, I talked about this with Andrea Treina. Her background is in clinical pharmacy and now she's an obesity director at Novo Nordisk. That's the company that makes Ozempic and Wegovy. And Emily, at my request, she went full frizzle during our interview.

[Emily Kwong]

So like the magic school bus Ms. Frizzle.

[Sidney Lupkin]

That is correct.

[Emily Kwong]

Our generation science teacher 100%.

[Sidney Lupkin]

Here is her primer on GLP1s and GLP1, by the way, is a hormone your body naturally makes. It stands for glucagon, like pest peptide 1.

[Andrea Treina]

As soon as you ingest food, your body is gonna start secreting GLP1 because it immediately triggers that oh, you've ingested some food and so it's gonna tell your brain you're eating and so it's gonna make sure it triggers that effect so that you start to feel full. But it's very short acting and only lasts a couple of minutes.

[Emily Kwong]

Oh, okay. So in our bodies, the GLP1 hormone does a good job of making you feel satisfied, but only for a short time. How does GLP1 medication work differently?

[Sidney Lupkin]

It much longer. When Novo Nordisk made its medication version of GLP1, the company tweaked it. The active ingredient in both blockbuster drugs, Ozempic and Wegovy is called Semaglutide. Andrea explained how they made it.

[Andrea Treina]

We took out a couple of amino acids and exchanged them for other ones so that the molecule can't immediately be degraded by the enzyme that our body naturally makes to break it down. And then the second thing we did is we added a big fatty acid chain to the end of it so that it binds to protein and hangs out in the body for longer. So semaglutide actually has a half life of a week instead of just two minutes.

[Emily Kwong]

Oh, okay. So this is why the retooling of the GLP1 hormone is why Ozempic and similar injectables are taken weekly. Because the chemical at the core of it all, semaglutide, has a half life of a week.

[Sidney Lupkin]

Right. By the way, there are four different blockbuster injectables. Ozempic and Mounjaro are for type 2 diabetes, and WeGovy and Zepbound are for obesity. But the latest twist is that now there's a possibility of a pill. Two pills, actually. And to be clear, we're not talking about Rubelsis, which is a semaglutide pill, but it's approved for type 2 diabetes.

[Emily Kwong]

Got it. Okay, these are two new pills, folks. A semaglutide you can swallow and another different pill which is a new compound. Which pill do you want to talk about first?

[Sidney Lupkin]

Let's talk about the pill made by Novo Nordisk, whose active ingredient is semaglutide. It's a peptide, a protein.

[Emily Kwong]

Okay.

[Sidney Lupkin]

The problem is that in your stomach, the drug gets broken down too efficiently and too fast for the semagluti to get into the bloodstream and do its job all over your body. Andrea says to think about how your stomach breaks down some chicken that you've eaten.

[Andrea Treina]

Our body is trained to release enzymes and to attack those proteins almost immediately, to break them down into smaller pieces so that they can be absorbed. So for 100 years, we've been trying to make a protein, a peptide based molecule able to be absorbed orally.

[Emily Kwong]

This sounds like a tricky design problem. So how did the scientists at Novo Nordisk get around this and make that peptide based molecule that our bodies wouldn't immediately want to break down?

[Sidney Lupkin]

Yeah, they added something to it.

[Andrea Treina]

It is a very long chemical name, but it is abbreviated as snac.

[Sidney Lupkin]

S, N, A, C. Adorable.

[Andrea Treina]

Isn't that cute? Thank goodness. No pun intended. But it is just the first letter from each of the chemicals within the structure. And it just worked out to be snack.

[Sidney Lupkin]

And I love that. And I also love that.

[Emily Kwong]

Okay, how does the snack pill take a ride through your body? Please be my Ms. Frizzle.

[Sidney Lupkin]

I'll let Andrea explain it. But the gist is that this snack thing creates a little protective buffer zone around the pill to keep it from getting broken down too quickly and help it get absorbed into the bloodstream.

[Andrea Treina]

When you swallow that tablet, it creates a tiny little micro environment at the base of the stomach right where that tablet sits. And so it's kind of, 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, it creates this little foamy environment directly, directly around the tablet.

[Emily Kwong]

Mmm.

[Sidney Lupkin]

Then it can do all those other things to make you feel full and regulate blood sugar. 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.

[Emily Kwong]

That's very specific. So this pill might not be for everyone.

[Sidney Lupkin]

Yeah, I definitely heard from people who were, like, past the injection is working for me. I'm good. I don't want this. But others were curious.

[Emily Kwong]

Now, earlier you had mentioned there was another pill that might come onto the scene. Who is making that one?

[Sidney Lupkin]

So that one is made by Eli Lilly, which makes the injectables Manjaro and Zepbound, and they both share the same active ingredient, called Tirzepatide. But unlike Novo Nordisk, which took its injectable active ingredient and made it in pill form with some tweaks.

[Unidentified NPR Staff or Sponsor Voice]

Yeah.

[Sidney Lupkin]

Eli Lilly is doing a whole new.

[Emily Kwong]

Active ingredient, a whole new compound for their pill formation. Okay, how does it work?

[Sidney Lupkin]

Eli Lilly isn't saying in detail yet, but I can tell you this. It is not a peptide. So it doesn't have the same restrictions around when you need to take it. You don't have to take it on an empty stomach and wait half an hour before eating anything.

[Emily Kwong]

That seems kind of nice.

[Sidney Lupkin]

Yeah, but its approval is probably a little ways behind the Novo Nordisk pill. And maybe here is a good place to spell out just how long the development and approval process for these drugs can be. I talked to Dr. Max Denning at Eli Lill, who's a senior medical director at the company and worked on studying the new pill.

[Dr. Max Denning]

You need a huge number of doctors, you need a huge number of sites to be participating in the clinical trials to get all of that data and make sure that this is safe and effective medication.

[Emily Kwong]

Okay, so Eli Lilly's putting their pill through clinical trials. Does this guy get to meet the patients?

[Sidney Lupkin]

Actually, never. His job was to design and oversee clinical trials for the pill and then step back. The trials are double blind, meaning that neither the patient nor the doctors know who got the drug and who got the placebo.

[Dr. Max Denning]

So you design these trials, you spend maybe six months doing that, you start them up and then you run the trial. And that process of finding all of the participants that come for all of their visits, take the investigational medicine as prescribed, then get to the end of the study. That whole process takes maybe two, two and a half years. And for me, the anticipation coming up to that first moment when the data card flips over and you see, does this medicine work?

[Sidney Lupkin]

Ooh, well, does it work also?

[Emily Kwong]

What is this pill called, by the way?

[Sidney Lupkin]

Oh, it's called Orfagliparon. And it did work. According to one study, patients who took Orphaglipron had 12% average weight loss at its highest dose over 72 weeks. And another study showed it it was also effective at lowering patients A1C, which is a measure of blood sugar.

[Emily Kwong]

Okay. How does this pill's efficacy compare to its competitor, the pill made by Novo Nordisk?

[Sidney Lupkin]

Novo Nordisk may have a bit of an edge here. In a study published in September in the New England Journal of medicine, a 25mg semaglutide pill led to a 16, 17% reduction in weight on average over 64 weeks. And that's about the same as WeGovy.

[Emily Kwong]

Oh, so the pill performed about as well as the injectable.

[Sidney Lupkin]

Yeah.

[Emily Kwong]

So, big picture. As a pharmaceuticals person, I know you've talked to many people over the years about GLP1 drugs. What do patients think of this?

[Sidney Lupkin]

Some just aren't into the idea. They're like, hey, the injections work for me. Why would I switch?

[Emily Kwong]

Yeah.

[Sidney Lupkin]

But overall, the pill is another option, and that's big, especially when it comes to cost.

[Unidentified NPR Staff or Sponsor Voice]

Yeah.

[Emily Kwong]

You said earlier that injectables can be over $1,000 a month, certainly a few hundred dollars a month, depending on your situation.

[Sidney Lupkin]

And that's on top of already high insurance premiums. So even if you have insurance coverage, it might be really limited or still require a big out of pocket payment.

[Emily Kwong]

Yeah. So are the pills going to be cheaper?

[Sidney Lupkin]

So we don't officially know what the sticker price for the pills is going to be yet. Novo Nordisk has not said, Eli Lilly has not said. But generally, pills are easier to manufacture, therefore they're cheaper to manufacture, which could result in a downstream lower price. We also know that there have been deals with the Trump administration announced earlier this year to sell the pills to consumers not using their health insurance for $149 a month.

[Emily Kwong]

Wow.

[Sidney Lupkin]

Now, that is not a sticker price, but it could mean that a lower sticker price is coming, and that could mean better insurance coverage, more access, basically just more people able to get their hands on these if they need them.

[Emily Kwong]

Sidney Lupkin, thank you so much for joining us.

[Sidney Lupkin]

Thank you for having me.

[Emily Kwong]

This episode was produced by Rachel Carlson and edited by Brent Baughman. Tyler Jones checked the facts. The audio engineer was Kwesi Lee. Beth Donovan is our vice president of podcasting. I'm Emily Kwong. Thank you for listening to Short Wave from NPR.

[Dr. Max Denning]

Foreign.

[Capital One / LinkedIn / Indeed / Vanta / BetterHelp / Shopify Announcer]

This message comes from vanta. What's your 2am Security worry? Is it do I have the right controls in place or are my vendors secure? Enter Vanta. Vanta automates manual work so you can stop sweating over spreadsheets, chasing audit evidence and filling out endless questionnaires. Their trust management platform continuously monitors your systems, centralizes your data and simplifies your security at scale. Get [e-mail] that's V A N T.

[Unidentified NPR Staff or Sponsor Voice]

A dot com this message comes from BetterHelp. The holidays are a time of traditions like making your grandmother's pudding recipe or watching that movie you've seen a thousand times. Incorporating therapy into your life can help you take time for yourself during what can be a joyful but sometimes tough time of year. And by caring for yourself, you can show up more for the important moments this December. Start a new tradition by taking care of you. Visit betterhelp.com NPR for 10% off. This message comes from NPR sponsor Shopify. No idea where to sell? Shopify puts you in control of every sales channel. It is the commerce platform revolutionizing millions of businesses worldwide. Whether you're a garage entrepreneur or IPO ready, Shopify is the only tool you need to start, run and grow your business without the struggle. Once you've reached your audience, Shopify has the Internet's best converting checkout to help you turn them from browsers to buyers. Go to Shopify.com NPR to take your business to the next level. Today.