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Why the new GLP-1 pill is such a big deal

The FDA just approved Foundayo. Here’s what it can and can’t do.

The semaglutide revolution took its next leap forward on Wednesday: The Food and Drug Administration has approved Eli Lilly’s GLP-1 oral pill for sale in the United States.

The approval for the drug, which will be sold under the brand name Foundayo, marks an important technological inflection point for this class of drugs that is transforming obesity care in the US and around the world. The previous generation of GLP-1 treatments were injections: Patients (or their doctors) had to handle a needle and insert it into their body in order to reap the weight-loss benefits.

It’s hard to estimate exactly how much Americans’ needle aversion has tamped down their uptake of GLP-1 drugs. Other factors — especially costs, as well as concerns about long-term safety and side effects, and a preference for other weight-loss tactics — have undoubtedly played a role, based on patient surveys. But the gap between the share of Americans who have tried a GLP-1 drug (about 12 percent as of last year) and the share who are obese (about 37 percent) suggests there is a sizable percentage of people who could benefit from these drugs but have not been taking them.

It’s possible some of those holdouts were waiting for a more convenient option, without the hassle of a needle — and Lilly is betting their new pill will make GLP-1s accessible for many of them.

“This is an oral medication in the sense that we’re used to an oral medication that we can just put it in our Monday, Tuesday, Wednesday, Thursday tray and take it with our other oral medications without regard to food or most worries about drug interactions or anything like that,” Eli Lilly CEO Dave Ricks told me in an interview last week. “That’s pretty different from a weekly injectable. Obviously, a lot of people use weekly injectables very successfully. But what we’ve learned, I think, is that there are a lot of people waiting for something like this. It’s just a little easier to fit into their busy life.”

How those hopes play out in reality now that the FDA has given its green light remains to be seen. And, as always, a new drug comes with some caveats and tradeoffs. Here’s what you need to know.

Why Lilly’s GLP-1 drug is a big deal

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