SCOTT DETROW, HOST:
2025 was another big year for blockbuster weight loss drugs, and their momentum does not seem to be slowing anytime soon. So as people add losing weight to their list of New Year's resolutions, they might be considering trying one of these drugs known as GLP-1s. NPR pharmaceuticals correspondent Sydney Lupkin is here to chat about what is in store for these drugs in 2026. Happy New Year.
SYDNEY LUPKIN, BYLINE: Happy New Year.
DETROW: So what is the biggest shift looking forward in the world of GLP-1s?
LUPKIN: Well, the big news is there's a pill. Until now, they've largely been injectable drugs - Ozempic, Wegovy, Mounjaro, Zepbound. They're all weekly shots. The Food and Drug Administration approved the Wegovy pill on December 22. It has the same active ingredient as Ozempic and Wegovy, which is semaglutide, and studies show it's about as effective as the injections when it comes to weight loss. And a competing pill made by Eli Lilly could get approval this year.
DETROW: I think injecting yourself is not really on anybody's list of things they...
(LAUGHTER)
DETROW: ...Look forward to, so I could see pills being really popular or something that's really in demand. What's the pricing situation?
LUPKIN: Yeah. So the drug companies promised the Trump administration that the pills would be available for $150 a month for people not using their health insurance. That was part of the administration's slew of deals with the drug companies to get them to lower some prices in exchange for tariff exemptions. But I should add that $150 is just the starting dose price. The higher doses that patients work their way up to will be $300 a month for the Wegovy pill and $400 a month for the Eli Lilly pill. For the Wegovy pill, those prices go into effect January 5. However, it's not clear yet just what the list price will be, which affects insurance coverage. But the company says people with coverage could have co-pays of as little as $25 a month.
DETROW: So it seems like people will still be using the injections one way or the other. Are they getting cheaper for people who want them?
LUPKIN: The answer is it's complicated. So normally, the makers of new brand-name drugs get a government-granted monopoly on their product for a number of years - basically, a reward for all that research and development. And then when the clock runs out, generic drugs get FDA approval and the competition brings prices down. Well, for GLP-1s, there are no generics yet, but you might have seen telehealth companies like Hims and Ro offering what are called compounded versions of these drugs. They're made with the same active ingredient as the brand-name versions, but by a specialized pharmacy, not a drug company.
In this case, the original brand-name drugs were so popular that there were widespread shortages. That opened the door for compounding pharmacies to pitch in, and their prices were lower. And that is having an impact on prices across the board.
DETROW: And does that stretch to the brand-name drugs, then?
LUPKIN: It does. Starting last year, both companies making name-brand GLP-1s - Novo Nordisk and Eli Lilly - started selling them to patients at a discount, but only if they weren't using their health insurance. They had to compete with the companies offering compounded versions, and those prices have gotten lower over time.
DETROW: So we've been talking about the price just as it is. What about people who are trying to use insurance for these drugs?
LUPKIN: That is where things get trickier. The drugs' sticker prices - also called list prices - haven't gone down. These have an impact on insurance coverage. Broadly speaking, insurance coverage specifically for weight loss has become more restrictive. For example, maybe only people with a body mass index over 40 can get a GLP-1 covered, even though obesity is classified as having a BMI of 30 or higher. That said, the Food and Drug Administration has been approving new uses for GLP-1 drugs over time. So with continued studies of potential new uses for these drugs, we could see broader and better coverage in 2026 and beyond.
DETROW: That is NPR pharmaceuticals correspondent Sydney Lupkin. Thank you so much.
LUPKIN: You bet. Transcript provided by NPR, Copyright NPR.
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