By Long Tran, Pharm D; Beckie Fenrick, Pharm D; and Jason Peterson, RPh
New products are only part of what’s changing in the GLP-1 market. The category is expanding while becoming more fragmented, more accessible through new channels, and more complicated for benefit strategy. Oral products are entering the market, pricing models are shifting, and direct-to-consumer pathways are expanding, influencing how members access these drugs.
For brokers and their groups, the question is no longer which GLP-1s are available. It’s how these changes affect utilization, affordability, and plan decision-making.
Oral GLP-1 Drugs: New Approvals and Market Impact
On April 1, 2026, Lilly announced FDA approval of Foundayo (orforglipron) for adults with obesity or those who are overweight with a weight-related comorbidity. That makes it the second oral GLP-1 approved for obesity and another signal of growing momentum in non-injectable formats.
With Foundayo’s approval, it is now positioned alongside oral Wegovy, which was approved in late 2025. Early research suggests oral Wegovy may have an edge in weight loss, tolerability, and cardiovascular risk reduction, while Foundayo, appears to offer stronger glycemic control (A1c), non-inferior cardiovascular results compared with insulin glargine, and a simpler dosing schedule without food or water restrictions.
Even as oral options grow, injectable GLP-1s remain central to the category. For weight loss, injectable GLP-1s often produce better results than oral GLP-1s and continue to serve as the backbone of the class. Weekly injectable dosing may also be more convenient for some patients than daily oral treatment.
At the same time, oral GLP-1s may appeal to patients who are needle averse, have difficulty self-injecting, or face logistical barriers related to refrigerated injectable products. Because of that, oral agents may become a preferred starting point for some new patients, even if they do not replace injectables more broadly.
GLP-1 Formulations: New Options and Dosing Changes
Recent formulation changes are also expanding the GLP-1 market.
- Zepbound KwikPen recently became available as a multidose formulation that allows for a full month of treatment in one device, improving convenience and giving patients and providers another option to align with treatment preferences. Zepbound KwikPen is available through direct-to-consumer channels and is not currently accessible through the pharmacy benefit.
- Wegovy HD, a once-weekly injectable semaglutide 7.2 mg product, was approved in March 2026. It offers greater weight loss potential than the 2.4 mg dose and brings results closer to those of Zepbound, though it’s also associated with a higher incidence of gastrointestinal side effects.
- Novo Nordisk is preparing to retire the Rybelsus name as it transitions to the more recognizable Ozempic tablet name, with rollout planned for the second quarter of 2026. While an official sunset date for Rybelsus has not been announced, communications to support patient transitions are expected.
GLP-1 Pipeline: Drugs in Development and Expected Approvals
The next phase of GLP-1 market growth will likely be shaped by late-stage pipeline activity. Several therapies in development could influence competition, positioning, and future utilization:
| Drug | Manufacturer | Modality | Key Differentiator | Expected Approval |
| CagriSema | Novo Nordisk | Injectable | Strong weight-loss results; slightly less than Zepbound in head-to-head study | Late 2026 |
| Aleniglipron | Structure Therapeutics / Gasherbrum Bio | Oral | Competes with oral GLP-1s; studied for obesity and other conditions | 2028-2029 |
| Retatrutide | Lilly | Injection | Targets three hormone pathways; strong blood sugar and weight loss results | 2027-2028 |
| Survodutide | Boehringer Ingelheim | Injectable | Developed for obesity and MASH | TBD |
| MariTide | Amgen | Injectable | Different mechanism; potential for monthly dosing | TBD |
GLP-1 Indications: Current Uses and Emerging Conditions
In addition to approved use in diabetes and obesity, GLP-1s are being studied across a wider set of conditions that could increase future utilization.
Current approved uses across the GLP-1 landscape include:
- Weight Loss: Saxenda, Wegovy (injection), Wegovy (tablet), Zepbound, Foundayo
- Type 2 Diabetes: Byetta, Bydureon, Victoza, Trulicity, Ozempic (injection), Rybelsus/Ozempic (tablet), Mounjaro
- Major Adverse Cardiovascular Events (MACE) Risk Reduction: Victoza, Trulicity, Wegovy (injection), Wegovy (tablet), Ozempic (injection), Rybelsus/Ozempic (tablet)
- Metabolic Dysfunction-Associated Steatohepatitis (MASH): Wegovy (injection)
- Chronic Kidney Disease (CKD): Ozempic (injection)
- Obstructive Sleep Apnea (OSA): Zepbound
Additional research is also underway in areas such as neurodegenerative disorders, cardiovascular disease, osteoarthritis, and substance use disorder. Foundayo is also being evaluated across several potential indications beyond obesity, including type 2 diabetes, obstructive sleep apnea, osteoarthritis knee pain, hypertension, peripheral artery disease, and stress urinary incontinence.
GLP-1 Pricing Trends and Access Changes
Recent developments point to meaningful change in how GLP-1 affordability is being addressed. Manufacturer direct-to-consumer programs from Lilly and Novo Nordisk now offer branded GLP-1 medications at substantially reduced prices compared with list price. Novo Nordisk has also introduced a multi-month Wegovy subscription program covering both injectable and oral versions, giving self-pay patients a more predictable monthly cost.
The market is also seeing signs of government involvement in affordability for Medicaid plans, along with TrumpRx, a direct to consumer pricing portal where consumers can access deep discounts on certain medications. This may influence how members access certain GLP-1 products outside the traditional benefit structure.
In addition, Novo Nordisk has announced a future list price reduction for Wegovy, Ozempic, and Rybelsus beginning January 1, 2027.
Taken together, these developments are creating new affordability benchmarks and raising new questions about plan strategy. If members can access certain GLP-1s through direct-pay or alternative purchasing channels at lower prices, employers and advisors may need to rethink how coverage decisions are evaluated and communicated.
GLP-1 Trends and Their Impact on Benefit Strategy
This is no longer just a story about expensive GLP-1 drugs. It’s a story about a category that’s becoming easier to access, harder to manage, and more important to benefit strategy.
Oral products may expand demand. New formulations may create more individualized treatment pathways. Broader indications may widen utilization. And new purchasing models may begin to shift how affordability is judged both inside and outside the benefit.
For brokers and groups, the most important role is to help employers understand what these market changes could mean for utilization, member expectations, and long-term plan strategy.
If you’re evaluating how these developments may shape your pharmacy benefit strategy, reach out to Navion to continue the conversation.
