Australia's Therapeutic Goods Administration has registered four strengths of Wegovy in tablet form, making it the first GLP-1 medicine approved in the country as an oral option specifically for weight management. The approved strengths are 1.5mg, 4mg, 9mg and 25mg.

Wegovy contains semaglutide, a medicine that copies the action of glucagon-like peptide-1, a naturally occurring hormone involved in regulating blood sugar, appetite and digestion. Semaglutide acts on the brain and digestive system, reducing hunger, increasing fullness and slowing how quickly food leaves the stomach.

The daily routine the needle avoided

The tablet is not a straight swap for the weekly shot. It must be taken daily on an empty stomach with a small amount of water, followed by a 30-minute wait before eating or drinking anything else, and it contains an absorption aid to survive stomach acid.

The injection, by contrast, goes in once a week at any time of day, with or without food. Anyone who assumes the pill is the easier format should read that paragraph twice.

Similar numbers, different failure modes

Trials showed similar gastrointestinal effects for both formats, particularly on starting, and similar overall weight loss: 14 per cent of body weight over 64 to 68 weeks for the tablet, against 15 per cent for the injection. Common side effects, affecting around 80 per cent of patients, include nausea, vomiting, diarrhea, indigestion and constipation.

Less common but more serious effects include kidney injury, pancreatitis and gallbladder problems, and the authors note that higher doses make negative effects more severe. Previous research has also highlighted a link between suicidal thoughts and GLP-1 use, which short appointments may not leave room to screen for.

What it will actually cost

Approval is not availability. The TGA still has to complete a final review of packaging, production and retail pricing, and Novo Nordisk is aiming for shelves by the end of the year.

Wegovy is not subsidized through the Pharmaceutical Benefits Scheme for weight management, so patients should expect the full price. Official pricing has not been released, but the weekly injection runs A$250 to A$450 a month and the pill's out-of-pocket cost is likely to be similar.

Bottom line

The TGA approved the tablets for use alongside a reduced-calorie diet and increased physical activity, not on their own. Follow-up research has found people regained about two-thirds of the weight they had lost within a year of stopping these medications.