Noom expands its GLP-1 range with 'microdose' package

Digital health company Noom has started offering lower doses of GLP-1 agonist semaglutide, the active ingredient in Novo Nordisk's weight-loss drug Wegovy, at a knock-down price.

The 'microdose' package costs $119 initially, then $199 per month thereafter, and is claimed to "unlock weight loss and long-term health benefits while minimising side effects" through "personalised" dosing.

Noom is basing its offering on a quarter dose of semaglutide – 0.6mg per injection versus 2.4mg for Wegovy – and said the rationale for the dose reduction comes from data gleaned from its members, as well as a couple of investigator-led studies published in The Lancet and New England Journal of Medicine.

The company started selling a compounded version of semaglutide last year, when the drug was still on the FDA's shortage list. While no longer in short supply – meaning that compounding should no longer be possible – some companies have continued to provide the drug to patients under exceptions for 'personalised' treatments under a framework known as Section 503A.

In a nutshell, that allows compounders to make compounds in small quantities for patients whose needs are not met by a standard formulation.

That interpretation of the rules is being challenged in the courts by Novo Nordisk and Eli Lilly, which makes rival weight-loss therapy tirzepatide, while the compounders have countersued, claiming that the FDA's removal of the drugs from the shortages list was premature.

Noom claims its microdose approach allows users to lose up to 11 pounds (around 5kg) in one month and up to 17 pounds in two months, with 70% of them reporting no side effects. At regular doses, semaglutide and tirzepatide are associated with tolerability issues in some patients, particularly gastrointestinal side effects.

Combining the low doses with Noom's GLP-1 Companion support app "helps more patients stay on the treatment, experience the full health benefits of these medications, and make real progress in reducing obesity and overweight rates in the US," said the company's chief medical officer, Dr Jeffrey Egler.

The company estimates that more than 50% of patients taking GLP-1 drugs stop because of costs, while more than a third do so because of side effects.

Novo Nordisk has launched its own telehealth programme for regular-dose semaglutide through its own channels, as well as other providers, for $499 per month, although a partnership with Hims & Hers quickly broke down due to what the company said were "concerns about […] illegal mass compounding and deceptive marketing."

Hims & Hers – which accused Novo Nordisk of 'anticompetitive' actions – is now offering a compounded version at $199 per month.