The Week Obesity Medicine Shook: Generics, MASH, CV Claims, and Lilly’s Exit

Dave Knapp
Sep 18
2 min read

Original posted at obesity.news/ on Sep 02, 2025

This week’s On The Pen podcast is one of the most important we’ve done yet. The headlines were loud — but the fine print tells a different story.

Teva’s “Generic” That Isn’t

The FDA just cleared Teva’s liraglutide injection as the first generic GLP-1 for weight loss. On paper, that sounds like a breakthrough for access. In reality? The wholesale price lands at $1,165. That’s double what many people pay cash for Zepbound or Wegovy.

And it gets worse. The diabetes twin of this very same drug, Victoza, is available generically for $200–300. That gap exposes what this really is — a win for pharma headlines, not for patients. If you were waiting for generics to mean affordability, the message is clear: not yet.

Wegovy Breaks Into MASH

Wegovy just received accelerated FDA approval for MASH (metabolic dysfunction-associated steatohepatitis). This is the first GLP-1 therapy for the condition, and it reinforces what patients already know in their bones: obesity is not just about weight. It’s liver, it’s heart, it’s whole-body health.

For every person told “your fatty liver disease is your fault,” this approval is vindication. Biology is finally speaking louder than blame.

Novo’s 57% Claim: Flashy, But Fragile

At the European Society of Cardiology, Novo Nordisk dropped a mic-worthy headline: Wegovy cut the risk of heart attack, stroke, or death by 57% compared to tirzepatide in real-world patients with obesity and CVD.

But dig in, and the foundation crumbles:

The study lasted only 3–4 months on average.
The event count was tiny — 15 vs 39 events.
Patients with diabetes weren’t included.
That 57% figure only held if patients had zero treatment gaps. Include real-world interruptions, and it drops to 29%.
And this wasn’t randomized — it was database analysis with all the messiness that brings.

Does semaglutide likely have heart-protective benefits? Absolutely. But Novo’s executives framing this as proof semaglutide “stands apart” is marketing bravado more than settled science.

Lilly Bows Out of Naperiglipron

Eli Lilly quietly discontinued two mid-stage studies of naperiglipron, one of its oral GLP-1 candidates. They’ll keep pushing orforglipron forward, but this shows just how brutal the path to oral incretins really is.

Even the giants can’t brute-force biology. And for patients waiting on an effective GLP-1 pill, this is another reminder that injections will likely remain the backbone of treatment, at least for now.

Why It Matters

This week was about access, expansion, advantage, and attrition. A generic that isn’t affordable. A new indication that expands hope. A flashy claim that needs caution. A pipeline setback that narrows the future.

Through it all, the question stays the same: will patients be treated like people, or like profit margins?

👉 For deeper coverage, visit Obesity.News.

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