5 GLP-1 Trends to Expect in 2025: Expanded Uses, Generics, Oral Options, and More

Originally developed for Type 2 diabetes, glucagon-like peptide-1 (GLP-1) receptor agonists have transformed the weight-loss medication market. And in recent years, their popularity has soared due to their effectiveness and versatility.

As we look ahead into 2025, several key trends are set to redefine the GLP-1 landscape — from broadening applications to shifts in coverage. Here’s a closer look at what to expect.

What are GLP-1 receptor agonists?

GLP-1 receptor agonists mimic a natural gut hormone in the body called GLP-1. GLP-1 is involved in regulating blood glucose (sugar), appetite, and digestion. GIP/GLP-1 receptor agonists work in a similar way. But they mimic GLP-1 and a second hormone called glucose-dependent insulinotropic polypeptide (GIP) for added benefits.

Most GLP-1s are injectables. But one oral option, Rybelsus (semaglutide), is available. Currently, there are 10 FDA-approved GLP-1 medications:

*Considered a GIP/GLP-1 receptor agonist

Next, let’s explore five GLP-1 trends to watch in 2025.

1. Expanded uses

GLP-1 medications are primarily used for Type 2 diabetes, weight loss, and to lower the risk of serious cardiovascular events. And recently, Zepbound was approved for obstructive sleep apnea. But they could gain approval for new uses in 2025, including:

• Chronic kidney disease (CKD): Ozempic is under FDA review for CKD in people with Type 2 diabetes, with a decision expected in January 2025. Studies show it can lower the risk of major kidney disease-related events by 24%.

• Heart failure with preserved ejection fraction (HFpEF): Semaglutide and tirzepatide have significant potential for HFpEF in people with a larger body size. Obesity is a potential cause of HFpEF and can worsen symptoms, making GLP-1s a natural fit for treatment. Tirzepatide’s manufacturer submitted an application for HFpEF in late 2024, with potential approval in 2025. Semaglutide’s manufacturer plans to follow suit in early 2025.

• Metabolic dysfunction-associated steatohepatitis (MASH): GLP-1s are showing potential to reduce liver inflammation caused by MASH, a health condition related to excess fat in liver cells. Semaglutide’s manufacturer plans to submit an application for MASH approval in early 2025. And positive results from tirzepatide’s phase 2 trial may lead to further development.

Examples of other potential uses under investigation include early Alzheimer’s disease, polycystic ovary syndrome, and substance use disorders.

2. New injectable GLP-1s

Several promising injectable GLP-1 therapies are in development, with the potential to deliver even better results. Of these, CagriSema appears to be among the furthest along.

CagriSema is semaglutide co-administered with cagrilintide. Cagrilintide is a new, long-acting medication that acts like amylin. Amylin is a hormone that helps promote fullness after meals. The effects of semaglutide with amylin appear to be greater than either medication on its own.

EXPERT PICKS: WHAT TO READ NEXT

• GLP-1 savings guide: Learn about ways to save on glucagon-like peptide-1 (GLP-1) medications, like Ozempic (semaglutide), with GoodRx discounts, copay savings cards, and more.

• Is semaglutide in shortage? Learn more about why semaglutide is in shortage and when the shortage could resolve.

• Next generation weight-loss pills: Orforglipron and danuglipron are two oral GLP-1 medications in development. Here’s what you should know about “gliprons" for weight loss.

In clinical trials, CagriSema helped people lose nearly 23% of their starting body weight over 68 weeks — more than Wegovy’s 16% weight loss. The manufacturer is planning a new trial in the first half of 2025 and expects to file for approval later in the year.

Additionally, head-to-head trial results comparing CagriSema to tirzepatide, the current leader in weight-loss effectiveness, are expected in 2025. CagriSema is also being studied for weight loss in people with Type 2 diabetes and for cardiovascular benefits in people with heart disease.

Other promising injectable GLP-1 medications advancing through clinical trials include:

• Retatrutide

• Survodutide

• VK2735

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3. Oral options

Not everyone is comfortable with giving themselves shots, which makes oral GLP-1 medications an appealing alternative. Today, Rybelsus is the only oral GLP-1 receptor agonist available. But additional options are also on the horizon.

• Higher Rybelsus doses: Rybelsus is currently approved in doses up to 14 mg for Type 2 diabetes. But higher doses (25 mg, 50 mg) are being studied for weight loss and improved diabetes management. These doses have shown weight-loss results comparable to the highest Wegovy dose. They were also superior to the 14 mg dose for diabetes. FDA approval for higher doses could come as early as 2025, depending on when the application is submitted.

• Orforglipron: Unlike peptide-based GLP-1s, orforglipron is made using chemicals. This can make it easier and less expensive to produce. Phase 3 trial results are expected in 2025. If successful, orforglipron could offer a lower-cost oral alternative.

4. Generics

For many people, the cost of GLP-1 medications can be a barrier to accessing them. One way to address this is through lower-cost generics. In 2024, the first two generic GLP-1s were approved: exenatide (Byetta) and liraglutide (Victoza). And we could see additional Victoza generics in 2025.

Teva Pharmaceuticals launched an authorized generic of Victoza, a once-daily GLP-1 medication, in June 2024. This product is the exact same medication as Victoza, but without the brand name. And in December 2024, the FDA approved the first Victoza generic, manufactured by Hikma Pharmaceuticals. This was shortly after the FDA approved the first generic of Byetta, a twice-daily GLP-1 medication.

Several other manufacturers have requested approval for their Victoza generics, including Sandoz and Viatris (formerly Mylan). It’s possible that these generics could be approved and launched in 2025. But generics for newer GLP-1s like Ozempic likely won’t happen until at least 2030.

5. Insurance coverage changes

Insurance coverage for GLP-1 medications is expected to shift in 2025. This may be due to factors such as broadening applications, policy proposals, and decisions by various insurers.

• Coverage for new indications: Approvals for CKD, HFpEF, and MASH could lead to broader insurance coverage. For example, insurers began covering Wegovy for some people with heart disease after it was approved to reduce cardiovascular risks in 2024.

• Dropped coverage for weight loss: High costs and discontinuation rates are leading some insurers to cut back on weight-loss drug coverage. Blue Cross Blue Shield of Michigan and Independence Blue Cross, for instance, will stop covering GLP-1s for weight loss in certain plans starting January 2025. And Kaiser Permanente is dropping GLP-1 coverage for people with a body mass index below 40 when the medications are used solely for weight loss.

• Proposed Medicare and Medicaid coverage: The Biden administration has proposed a rule to expand Medicare and Medicaid coverage of GLP-1s to include weight loss. This proposal has the potential to benefit approximately 3.4 million Medicare beneficiaries and 4 million Medicaid beneficiaries. But its future remains uncertain, especially with the transition to a new administration.

• Stricter utilization controls: GLP-1 access may be limited by stricter prior authorization requirements, step therapy protocols, and formulary changes going into effect in 2025. For example, the Chevron Prescription Drug Program will require active participation in a virtual health program, regular weigh-ins, and a minimum amount of weight loss for continued coverage. Another example is MassHealth, which will require people to try phentermine first before covering new GLP-1 prescriptions.

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Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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