Although it is the same active ingredient, semaglutide, the oral version of Vigobi contains a much higher dose than the injection. The reason for this lies in absorption. When the drug is swallowed, only a small part of it is absorbed into the bloodstream. The maintenance dose of the pill is 25 milligrams, compared to significantly lower doses in the injection. According to the company’s data, despite the difference in dosage, the clinical effectiveness is very close to that of the injection.
307 subjects participated in a clinical trial funded by Novo Nordisk. 205 of them received the Vigobi pill, and 102 received a placebo. After 71 weeks, an average decrease of 13.6% of body weight was recorded in the treatment group, compared to a decrease of only slightly more than 2% in the placebo group. For comparison, previous studies have shown that Vigobi injection patients lose an average of 15% of their body weight during a similar period. The gap is considered relatively small, especially given the potential comfort of handling the ball.
Vigobi’s approval of the pill comes amid increasing competition in the obesity drug market. The Eli Lilly company that produces the competitor from Ungero is expected to launch its own oral slimming drug called orforglipron in the coming months. Estimates are that the global market, which already generates tens of billions of dollars a year, will continue to grow rapidly.
Alongside the great promise, experts warn against over-optimism. Results of controlled clinical trials do not always reflect everyday reality. The actual effectiveness, doctors emphasize, depends on persistence, the lifestyle and the ability of patients to comply with the instructions for taking. In the case of a Vigobi pill, the medicine must be taken on an empty stomach, immediately upon waking up, and avoid food and drink for about half an hour. For some patients, this requirement may harm comfort and affect compliance with treatment.
Another open question concerns the cardiovascular effects. The Vigobi injection has already been approved to reduce the risk of heart attacks, strokes and other cardiac events in people with obesity. Biologically, there is no reason in principle that the oral version would not provide a similar benefit, but this would require further research and dedicated regulatory approvals.
The price issue also concerns the market. In November, Novo Nordisk announced, as part of an agreement with the US government, that the monthly price of the low starting dose of the pill would be $149. Initial doses usually do not lead to significant weight loss, but are intended to accustom the body to the drug before gradually increasing the dose. Prices for the higher doses have not yet been published, and they may significantly affect the accessibility of the treatment.
Despite all this, the doctors agree that the very possibility of choosing between an injection and a pill changes the treatment experience. For many patients, the mere avoidance of injections may remove a significant psychological barrier and lead to earlier treatment. On the other hand, it is important to mention that weight loss drugs are not a magic solution. They are an effective medical tool, but one that requires accompaniment, customization and integration with a change in lifestyle.
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