Our latest Best Practices in Healthcare survey offers fresh insights into how employers are approaching coverage of GLP-1 therapies for weight loss. While full results will be released soon, early findings, combined with recent market developments, paint a clear picture of a rapidly shifting landscape:
These data points reflect growing interest, tempered by cost concerns, as employers weigh the value and sustainability of GLP-1 coverage. Meanwhile, the broader GLP-1 landscape continues to evolve across clinical, commercial and intellectual property fronts.
Novo Nordisk’s Wegovy® (semaglutide) received FDA approval for Metabolic Dysfunction-Associated Steatohepatitis (MASH), formerly known as NASH. This new indication applies to individuals with moderate to advanced liver fibrosis (stages F2 to F3) and marks the first GLP-1 therapy approved for liver disease. Notably, this approval isn't contingent on the presence of obesity or overweight. It joins Rezdiffra® as one of only two FDA-approved therapies for MASH, with Rezdiffra, a specialty drug, averaging $50K/year.
Oral semaglutide for weight loss coming in November
Oral semaglutide is currently available under the brand name Rybelsus® for diabetes. A new oral formulation for obesity is under FDA review, with expected approval in November 2025. If approved, it would be the first oral GLP-1 therapy for weight loss, potentially changing patient adherence and reshaping market dynamics. According to the pharmacy analytics company, IPD, costs may align with injectable GLPs, though gastrointestinal side effects may be more common due to the higher dosing requirements needed to produce oral tablets.
Canadian patent expiration will allow generic semaglutide in 2026
Novo Nordisk’s Canadian patent for semaglutide expired in 2020 due to non-payment of maintenance fees, invalidating a supplementary protection certificate that would have extended exclusivity to 2028. As a result, generic semaglutide is expected to launch in Canada in early 2026, with Sandoz and Apotex among the anticipated entrants. Companies like HIMS also plan to enter the Canadian market to capitalize on early generic availability.
Direct-to-consumer (DTC) update
Employers are increasingly exploring the DTC channel as they reevaluate GLP-1 coverage. Novo Nordisk recently introduced a $499 cash-pay option for Ozempic via its NovoCare platform, with similar pricing available through GoodRx. Both Novo Nordisk and Lilly are partnering with platforms like 9amHealth, Form, Goodpath, Teladoc and WW to offer weight-loss GLP-1s directly to consumers. In these models, members pay out-of-pocket while employers provide wraparound support programs.
As GLP-1 therapies expand into new indications and delivery formats, employers face complex decisions around coverage, cost and member experience. We will continue to monitor these developments and provide strategic guidance to help organizations navigate this fast-moving space.
Glucagon-like peptides:
GLP-1 drugs like semaglutide (Wegovy and Ozempic) and tirzepatide (Zepbound and Mounjaro) were developed to treat type 2 diabetes, but they’ve gained media attention in the past couple of years for their ability to help people lose weight. These drugs are expensive and mostly given as a self-injection. The drugs to treat obesity and to treat diabetes are the same, although the obesity medications are more expensive and sometimes come in higher doses.
In addition to weight loss and better diabetes control, these drugs have been shown to decrease onset of diabetes in those with prediabetes, decrease progression to kidney failure, and decrease heart attacks in those at high risk. They are also approved for obstructive sleep apnea (Zepbound), metabolic liver disease (MASH, Wegovy), and heart disease prevention (Wegovy). Studies have shown lower risk of obesity-related cancers, too.
Employers should check with their pharmacy benefit manager (PBM) to confirm coverage options.
Yes, liraglutide, a once daily GLP-1 injection, has entered the market as a generic for diabetes (brand name Victoza) in December 2024, and for obesity (brand name Saxenda) in August 2025.
