What’s ahead in the GLP-1 market in 2026
The obesity rate has been increasing over time in the U.S. From August 2021 to August 2023, about 40% of American adults were considered obese. A recent study shows that these rates will continue to rise for about 20 more years. Complications related to obesity include heart disease, high cholesterol, sleep apnea, diabetes, and certain cancers.
Enter glucagon-like peptide-1s (GLP-1s), which have transformed obesity treatment, bent the curve, and brought the obesity rate down by almost 3%. In 2025, the obesity rate was estimated to be 37%. Originally developed to treat diabetes, GLP-1s are now on the market to treat obesity (and other conditions like sleep apnea and metabolic dysfunction-associated steatohepatitis [MASH]). GLP-1s mimic the hormone glucagon and slow down how fast food moves through the system, making people feel fuller more quickly.
In this blog, we look at where the GLP-1 for obesity market currently stands, where it’s headed, and what this could mean both for Americans and the U.S. healthcare system.
Current GLP-1s for Obesity
These GLP-1s are currently approved for weight loss:
- Novo Nordisk’s Saxenda® (liragutide) was approved in December 2014. As of June 2025, Saxenda had annual sales of $165 million. A generic version of Saxenda was approved in August 2025.
- Novo Nordisk’s Wegovy® (semaglutide) was approved in June 2021. In 2024, sales of Wegovy were about $8 billion. In December 2025, an oral version of Wegovy was approved, making it the first oral GLP-1 to treat obesity. The starting dose will cost $149 a month for patients paying cash, and the 4mg dose will be $149 a month through April 15. After that date, the cost will be $199 a month. The 9mg and 25mg doses will be $299 a month. Patients who pay in cash can also get the starting dose for $149 a month on TrumpRx under a deal the company made in November 2025. The Wegovy pill is now available nationwide.
- Eli Lilly & Co.’s Zepbound® (tirzepatide) was approved in November 2023. Zepbound had sales of about $4.9 billion in 2024. Tirzepatide is a dual agonist—it is both a GLP-1 and a glucose-dependent insulinotropic polypeptide (GIP).
A GIP is a hormone produced by the small intestine which encourages the release of insulin, thus helping to control levels of blood sugar.
In the Pipeline
Drugmakers are searching for the magic bullet—that combination of hormones that will best spark weight loss, maintain muscle mass, and cause the least side effects.
There are many new drugs in the pipeline, and some offer an oral version rather than an injection.
Some of these include:
- Oral orforglipron from Eli Lilly & Co. This is a once daily pill. In October 2025, the company announced positive results from Phase 3 trials. The company plans to sell it for up to $399 per month. In November 2025, the FDA granted the drug its Commissioner’s National Priority Voucher, meaning review time would be one to two months instead of the standard 10 to 12 months. In December 2025, Eli Lilly said it filed an application with the FDA and expects an action date of March 2026.
- CagriSema from Novo Nordisk. This is a combination of cagrilintide (an amylin analog) and semaglutide. Amylin is a pancreatic hormone secreted with insulin, and amylin analogs can help with glycemic control. CagriSema was submitted to the FDA in December 2025 and approval is expected this year.
- Amycretin from Novo Nordisk. This is available in both injection and oral forms. Amycretin is a GLP-1 and an amylin receptor co-agonist, meaning it activates amylin receptors and another metabolic receptor (in this case, GLP-1). The projected approval date is in 2030.
- Retatrutide from Eli Lilly. This is an injection and a triple-receptor agonist: GLP-1, GIP, and glucagon. Phase 3 trials should end early this year. It may be approved in late 2026 or early 2027.
In addition, a higher dose of semaglutide in an oral dosage/pill form is expected for approval at the end of 2026.
Utilization and Uptake of Weight Loss Medications
GLP-1 utilization has soared since 2021. In 2025, the market size of GLP-1s was expected to be over $62 billion. By 2034, the market size for GLP-1s could reach $268.37 billion.
About 12% of Americans have used a GLP-1 for weight loss. Use was highest in women age 50 to 64. And for those who have not taken a GLP-1, 22% said they would be interested in taking one for weight loss.
With greater use—and possibly even more use—of GLP-1s comes a rise in drug spend.
Traditional drugs have historically not been the main drivers of drug spend—specialty drugs often account for the bulk of drug spend. But a 2025 report from Evernorth Research Institute shows that with the increasing use of GLP-1s, traditional drug spend now surpasses specialty spend. Weight loss therapy contributed to a 46.8% increase in drug spend in 2024, and GLP-1s were the main reason. By the end of 2025, the increase in utilization of GLP-1s for weight loss was expected to be 73.1%.
As utilization increases, employers are grappling with how to respond to the surge in care costs. WTW’s Best Practices in Healthcare 2025 survey said that 57% of employers are currently covering GLP-1s for weight loss, but that 9% are thinking about removing this coverage. Seventy-three percent of employers say they are dealing with more cost pressure than ever in the past 10 years. And nearly 80% of employers would cover GLP-1s if the costs for doing so were lower.
Cost Changes
The price of weight loss drugs has fluctuated since they came on the market. In 2025, there were many changes related to direct-to-consumer pricing. The government also introduced pricing schemes for weight loss drugs.
In November 2025, Novo Nordisk and Eli Lilly entered into pricing agreements with the government under TrumpRx and lowered the cost of several weight loss drugs. If bought through TrumpRx, the monthly price of Ozempic and Wegovy will be $350—this is down from $1000 for Ozempic and $1350 for Wegovy. The TrumpRx price is for cash pay commercial and various other insured products from the government. The price of Zepbound will average $346 monthly, down from $1086. People on Medicare get an even lower price due to TrumpRx for these drugs than those paying the previously mentioned cash prices.
Also in November 2025, Novo Nordisk announced that it was decreasing the direct-to-consumer price of Wegovy and Ozempic for existing patients paying cash. In that announcement on November 17, 2025, Novo Nordisk said that Wegovy would cost $349 a month for cash payers and that the same cash price would apply to Ozempic (except the highest dose, which would stay at $499 per month). In December 2025, Eli Lilly announced additional price cutting for Zepbound under its direct-to-consumer platform. Beginning on December 1, 2025, people paying in cash can receive the starting dose of Zepbound for as little as $299 a month. The next dose up (5 mg) will be $399 a month and other doses will be $449 a month.
While it’s unclear what will happen with pricing in 2026, these current developments help to increase access to these drugs.
GLP-1s have shifted from being known as diabetes drugs to becoming a part of obesity treatment. The increased uptake of these drugs is already having effects on healthcare in the U.S. With the addition of even more therapies for weight loss, there could be more profound effects. There could be improved access, greater adherence, and possibly an expansion of the pool of patients who can be treated with these drugs. In 2026 and beyond, there is tremendous opportunity—but there are also challenges like cost and disparity in treatment. By combining innovation, expanded coverage, and additional support, there could be a major shift in the health and well-being of those living with obesity.
Interested in learning more about navigating GLP-1s?
Contact Scott Webb at [email protected]
