By Healthesystems
In December 2025, the FDA approved a new oral tablet formulation of Wegovy® (semaglutide), marking the first available GLP-1 drug for the treatment of obesity in an oral formulation.
Like GLP-1 injections, the new oral version is indicated in combination with a reduced calorie diet and increased physical activity to reduce excess body weight. Additionally, the tablets are approved to reduce the risk of major adverse cardiovascular events in adults with established cardiovascular disease who are either obese or overweight.
The new tablet formulation will be available in dosages of 1.5 mg, 4 mg, 9 mg, and 25 mg. Due to differences in how the body breaks down the oral version versus an injection, the pill comes in a higher dose than the injection and must be taken daily rather than weekly.
Let’s take a deeper look at this oral GLP-1 medication and its place in workers’ compensation.
Efficacy
Clinical trials show the new weight loss pill has efficacy similar to the injectable version of Wegovy. Those taking the highest dose of the pill lost 16.6% of their body weight, on average, after 64 weeks (compared with 2.2% weight loss in the placebo group), according to clinical trial results published in the New England Journal of Medicine. By contrast, the injectable version of Wegovy reduced weight by about 15% after 68 weeks.
It is worth noting that according to the package insert for the new tablet, patients must take the oral version of Wegovy daily and at least 30 minutes before eating food, drinking beverages, or taking other oral medications. This potentially could lead to adherence issues for injured worker patients, which could affect the efficacy of the medication.
Safety
Adverse reactions for the new weight loss pill are similar to the injectable version and can include nausea, diarrhea, vomiting, constipation, abdominal pain, abdominal distension, headache, fatigue, dyspepsia (indigestion), dizziness, eructation (burping), hypoglycemia in patients with type 2 diabetes, flatulence, gastroenteritis (stomach flu), gastroesophageal reflux disease, and nasopharyngitis (common cold).
Since Wegovy can lower blood sugar, it can interact with other medications that also lower blood sugar, resulting in extremely low blood sugar levels. Wegovy may also affect absorption of oral medications.
Considering the significant number of side effects and special warnings, patients prescribed Wegovy should be carefully monitored to avoid drug-drug interactions and additive adverse effects.
Cost
Initial reports note that there will be little cost difference between these oral tablets and the pre-existing injectables, despite hopes that an oral formulation would bring lower costs. A list price has not yet been released, but manufacturer Novo Nordisk reached a deal with the Trump Administration to sell the lowest dose of the tablet for $149 a month to people who pay out of pocket.
Place in Workers’ Comp
Because GLP-1 drugs have the potential to reduce the unfavorable impact that comorbid conditions have on workers’ comp claims, there has been a steady increase in their use in workers’ comp. Now, there is potential for utilization to increase as the oral tablet formulation presents a more approachable option for injured worker patients versus injectables.
Additionally, the new pill may be more widely available than the injectable version, which experienced prolonged shortages. Oral formulations are reportedly easier to manufacture, and Novo Nordisk has also boosted its production prior to launch in an effort to offset shortages.
For more information on obesity drugs and how they impact injured worker recovery, read our RxInformer magazine article, Weighing the Options: Keeping Track of New Obesity Drugs.
