Every commercial team with or developing an oral GLP-1 to market right now is chasing a ghost: the "pill patient." Younger: maybe, and based on the ads, companies seem to think so. Price-sensitive: that tracks. Needle-averse: definitely. Brand plans, ad campaigns and detail aids get developed around this persona.

After cutting Thrivable 365’s Q3 wave - comprised of 605 GLP-1 naive and experienced patients - we were surprised to see that no demographic pops when it comes to finding the patient that would consider an oral. BMI, sex, or age did not show us a clear break line. Our takeaway is that traditional demographics won’t predict who enters the market, particularly as new entrants come in.

Clinical trials and indication statements often lead the industry to BMI as a clear definer. The gap between the under-35 vs. the 35+ BMI mark on considering an oral was only 4.9 points. The difference on sex was 55.8% for women vs. 52.0% for men. When thinking about a segmentation strategy, using traditional markers may obscure the bigger opportunity. With seniors, we thought we saw a shift to orals and we still do see preference vs. injectables. However, when you isolate naive consumers, seniors are not more likely to consider a pill. Ironically, the opposite effect happened with sex. One hypothesis has been that men may be waiting for an oral option; but when looking at naive consumers, females were more likely to consider an oral vs males.

So where do we go from here? We have one take away and also a next area for future inquiry. The main takeaway based on our data is that a patient’s position in the treatment journey is currently the most important factor to look at.

Our latest Thrivable 365 report, titled How Patients View Current + Upcoming Weight Loss Options, combines conjoint, attitudinal, and patient-voice research to examine what motivates patients to begin GLP-1 weight-loss treatment, how they evaluate oral and injectable therapies, and where access, affordability, and product positioning may shape future market opportunities. PREVIEW THE REPORT >>

Naive patients — the ones who've never filled a GLP-1 prescription — considered an oral option 66.1% of the time. Patients currently on therapy: 38.9%. This may reflect the order of market entry, but there are some interesting insights. Our results indicate that those consumers already taking a GLP-1 are largely satisfied with their treatment, with 71.8% top 2 box satisfaction for current injectable users. A current patient injecting Zepbound already has a mental model of what "working" looks like — a number on the scale, a side-effect profile they've made peace with, a routine they've built their week around.

“Once I tried the injections at first I realized that it wasn't as bad as I thought it might be, and so I continued it for quite some time had some good results with it.”

- Former Ozempic user.

Switching to a pill means giving up a known result for an unknown one. A naive patient has no such anchor. They're not choosing between a pill and their current therapy; they're choosing between a pill and nothing. Every comparison a naive patient makes runs against zero, not against an injectable. That's an entirely different psychology.

Former patients — people who started a GLP-1 and stopped — land at 65.0% consideration, nearly matching the naive group. That's its own signal. These are patients who tried the injectable path, didn't stay on it, and are shopping again with a different, lower bar. An oral option isn't a lateral move for them. It's a second chance at a therapy that didn't stick the first time, in a format that might.

"I started taking the Wegovy pill because the Wegovy injections were no longer available through my insurance unless my BMI was 37. So I said, well, the Wegovy injections worked great. Let's try the Wegovy pills. They didn't work as good as the injections."

- Wegovy Pill user.

So, is the answer then to just find the patients who haven’t tried a GLP-1 and offer them an oral? Unlocking this group will take more than just a new format. In our conjoint analysis, administration method is not yet a differentiator, representing only 8% of the weight of a patient’s decision vs. 56% for cost and 26% for efficacy. Given the growth of the oral class to date, we suspect that cost and access may be what’s pulling new or even existing patients into that market. And, as our consumer quoted above shows, this may be a challenging strategy.

Back to that question: where do we go from here? At Thrivable and Clickspring, we think the next phase to unlock the market is to pay close attention to the total value proposition offered to patients. The initial launches of injectables and orals owed to word-of-mouth and earned media, strong efficacy experiences and new routes for fulfillment, both in terms of payment models and delivery. How to build a category and how to compete in a category will require a new level of customer-centricity. In Thrivable 365’s next wave we are evaluating what the functional, emotional and social roles an obesity medication fulfills for new and existing consumers. In doing so, our aim is to help those working in this market to approach consumers beyond just a position in a line of therapy or on a demographic. Consumers that we talk to have reasons that matter deeply, more so than their age or the number on the scale.

As we move forward, we are going to stop asking “who is the oral consumer,” and start asking “what are consumers looking for next” and how can the new innovations meet those needs. In doing so, we hope to help companies move beyond the magical combination of demographics and help build relationships for the right consumer at the right time and with the right information.

“The moment I decided to start taking GLP-1 was primarily when I realized that I wasn't able to do some of the activities that I wanted to [do] with my family.”

- Former User.

“I would like to research first. That would be my first step to see if it's a good fit for me.”

- Naive User

If you would like to join us in this endeavor, connect with Clickspring or Thrivable to request your readout once our next wave of Thrivable 365 data drops.