These requirements mirror those that may have limited adoption of Rybelsus, the oral semaglutide from Novo Nordisk approved for diabetes in 2019. One challenge in developing oral versions of semaglutide is that the drug is based on chains of amino acids known as peptides which are subject to degradation by enzymes in the stomach. In contrast, Eli Lillys upcoming oral GLP1 candidate, orforglipron, is a smallmolecule drug rather than a peptide, which could lessen the need for dosing requirements and offer greater convenience to users. This ease of use has fueled expectations of growing market share for oral GLP-1 formulations, with analysts estimating they could generate $22 billion annually by 2030, capturing 24% of the global weight loss market. For plan sponsors, the arrival of oral options means usage could grow, reinforcing the need for comprehensive utilization-management strategies
Food and nutrition insecurity Food security and nutrition security may influence efficacy of GLP-1s, as poor nutrition while on therapy can exacerbate GI side effects, nutrient deficiencies, and reduction of muscle mass
India demonstrates the highest growth at 28.4%, supported by rising obesity prevalence in urban populations and increasing availability of treatment through private healthcare channels
doi:10.1111/j.1399-3011.1992.tb00309.x
This mutation was reported in 2017 in a study assessing the genetic heterogeneity of NS5B by ultra-deep pyrosequencing in patients harbouring GT3a not achieving SVR
