NEJM perspective calls generic liraglutide an overlooked option

Three drug-pricing researchers published a perspective piece in the New England Journal of Medicine arguing that generic versions of liraglutide, an older GLP-1 receptor agonist, are being overlooked as a lower-cost route to treatment. The article, titled "Generic Liraglutide — Overlooked but Not Forgotten," was published online on December 10, 2025 ^[2].

The authors are Suhas Gondi, M.D., M.B.A., of the Department of Medicine at Massachusetts General Hospital in Boston, and Aaron S. Kesselheim, M.D., J.D., M.P.H., and Benjamin N. Rome, M.D., M.P.H., both of the Program on Regulation, Therapeutics, and Law (PORTAL) in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women's Hospital and Harvard Medical School ^[2].

The published summary states the core argument plainly: "The market entry of generic liraglutide could meaningfully reduce the fiscal burden of GLP-1 drug coverage, but only if patients, clinicians, and insurers choose to leverage this opportunity" ^[2]. In other words, the authors frame the savings as conditional. A generic existing on the market is not the same as a generic being prescribed, stocked, covered and dispensed.

What the sources do and do not contain

This is an important limit to flag. The full text of the article sits behind a subscription paywall, and the PubMed record carries no abstract ^[1][2]. That means the specific figures the authors use — how much generic liraglutide costs compared with brand-name GLP-1s, how many manufacturers have entered the market, or how much national spending could fall — are not available in the sources reviewed for this story. Reporting elsewhere has described the authors' case as arguing that stronger uptake could attract additional manufacturers and push prices down further, but those specifics are not verifiable from the material at hand and should be treated as not yet confirmed here.

What is confirmed: the piece runs in NEJM Volume 394, Number 2, dated January 8, 2026, on pages 107 to 110 ^[2]. NEJM indexed it under topics including cost of health care, insurance coverage, diabetes, obesity, Medicare and Medicaid, and drugs, devices and the FDA ^[2]. It appears alongside a related NEJM perspective, "Insurance Coverage and Pricing of Weight-Loss Drugs in the United States," and an accompanying audio interview with Rachel Sachs about "recent agreements governing coverage and pricing of GLP-1 receptor agonists in the United States" ^[2]. That packaging signals the journal is treating GLP-1 affordability as a policy cluster, not a one-off.

Why it matters for patients

Cost and coverage are the two biggest practical barriers many Americans hit with GLP-1 medicines. A commentary in a major medical journal does not change any price, any formulary or any prescription on its own. But perspective pieces in NEJM are read by the clinicians who write prescriptions and by the people who design insurance benefits, and the authors are explicitly addressing that audience — the summary names patients, clinicians and insurers as the groups whose choices determine whether savings materialize ^[2].

For someone weighing options, the takeaway is narrower than the headline suggests: an older, now-generic GLP-1 is part of the conversation among drug-pricing researchers, and health plans may face growing pressure to account for it. The article does not, based on what is publicly visible, compare how well liraglutide works against newer drugs such as semaglutide or tirzepatide, and no such comparison should be inferred from it.

What happens next

The piece appeared online December 10, 2025, and in print January 8, 2026 ^[2]. Early attention has been modest: an Altmetric score of 13, with posts from 18 users on X, one Reddit post and three Bluesky users ^[2]. Whether payers or pharmacy benefit managers respond by favoring generic liraglutide is not addressed in the available sources and remains unknown.