One of the biggest stories — arguably the biggest — in pharma this year was weight-loss drugs.
Every week seemed to bring a new development: soaring sales, widespread shortages, surprising health benefits, expanded public insurance coverage, promising clinical trials for next-gen drugs, and examples of their ripple effects across the wider economy. Even Congress got involved and held a hearing to pressure pharmaceutical companies to bring down these drugs’ high prices.
One of the most interesting subplots of this story has been the rise of low-price, off-brand alternatives. Digital health companies such as Noom, Hims & Hers (HIMS), and even WeightWatchers (WW) all began offering compounded versions of popular weight-loss drugs this year — essentially custom-made formulations — for hundreds of dollars less than the brand-name options. They were able to do this because current drug laws allow the sale of compounded versions of a drug when it is in shortage, which many weight-loss drugs have been in recent years. But the Food and Drug Administration (FDA) has recently said that some of these drugs are no longer in shortage, potentially jeopardizing this emerging market.
Quartz spoke with Noom CEO Geoff Cook to get his take on what 2025 holds for the compounded drug market and the overall future of weight-loss drugs. Cook took over as CEO of the psychology-based weight loss app Noom in 2023, the same year the company began offering its members prescriptions for weight-loss drugs. He believes that medicine will play an increasingly central role in how people approach weight loss in the future.
“Fewer and fewer people over the course of every year are going to consider losing weight without reference to some form of medical assistance,” Cook said. “It’s going to become more and more popular, medically-assisted weight loss.”
To adapt to this shifting landscape, Noom is positioning itself as a comprehensive solution, offering not only weight-loss medications but also supplemental support through its behavioral-change platform. This approach aims to help patients mitigate potential drug side effects, such as lean muscle mass loss, and ultimately help them taper off the medications entirely.
This summer, Noom started offering its members a compounded version of semaglutide — the active ingredient in Ozempic and Wegovy — starting at just $149.
Cook believes the FDA will declare an end to the shortage of weight-loss drugs in 2025, but the agency will then have to decide whether it will allow companies to continue to make and sell compounded weight-loss meds. If it doesn’t, millions of patients who aren’t covered by insurance and can’t afford branded weight-loss treatments could lose access.
But Cook said this scenario could also open the opportunity for companies to sell even more customized compounded products, with personalized dosing or different methods of administration — something that will still be permitted after the drug shortages end. Overall, Cook said, companies selling compounded weight-loss drugs will need to diversify to navigate this uncertainty.
“I think you’d continue to meet patient needs in a way that we think is legally compliant,” he said. “But at the same time, you’ll see us going to different conditions and treatments.”
He added that this wouldn’t be limited to just weight-loss dr