From payer shifts to regulatory milestones, GLP-1 therapies for obesity and diabetes continued to reshape the healthcare landscape in December.
Here are six updates:
- Pfizer struck a $2 billion deal with YaoPharma to develop and commercialize a small-molecule GLP-1 receptor agonist in phase 1 development for chronic weight management. Pfizer paid $150 million upfront and could pay up to $1.935 billion in additional milestone payments. The company also plans to evaluate the therapy alongside its phase 2 GIPR antagonist.
- The FDA approved the first oral GLP-1 for weight loss Dec. 22. Novo Nordisk’s once-daily 25-milligram semaglutide pill — a version of Wegovy — was cleared to reduce body weight and lower cardiovascular risk. Launch is expected in early January 2026. In clinical trials, one-third of participants achieved at least 20% weight loss.
- CMS unveiled its BALANCE model, a voluntary coverage pathway for GLP-1s under Medicare and Medicaid. The model includes price negotiations and supplemental lifestyle support. Coverage will begin in May 2026 for Medicaid and January 2027 for Medicare Part D, with bridge access beginning in July 2026. CMS Administrator Mehmet Oz, MD, said the model builds on the administration’s recent drug pricing agreements with Eli Lilly and Novo Nordisk.
- A growing number of older adults are discontinuing GLP-1 therapy, with 60% of patients over age 65 stopping semaglutide within one year, according to a Dec. 21 report in The New York Times. Cost, side effects and loss of muscle mass are contributing factors. The trend has implications for health systems as Medicare eligibility expands to include GLP-1s in 2026.
- Novo Nordisk filed for FDA approval of CagriSema, an experimental injectable combination of semaglutide and cagrilintide, which showed 20.4% average weight loss in a 68-week trial. If approved, it would be the first combination GLP-1 and amylin analogue therapy in the U.S.
- Eli Lilly shared positive trial results for two experimental drugs, orforglipron, a daily oral GLP-1 that helped maintain weight loss after discontinuing injectables, and retatrutide, a triple-hormone agonist that achieved 28.7% weight loss and reduced osteoarthritis pain in early trials.
