NEJM perspective calls generic liraglutide an overlooked lever on GLP-1 costs
A New England Journal of Medicine perspective argues that generic liraglutide could cut the cost of covering GLP-1 drugs, but only if insurers, clinicians and patients actually choose it.
Three Harvard-affiliated drug-pricing researchers argue in a New England Journal of Medicine perspective that the market entry of generic liraglutide could meaningfully cut the cost of covering GLP-1 medicines — but only if patients, clinicians and insurers choose to use it [2].
The article, "Generic Liraglutide — Overlooked but Not Forgotten," was published online on December 10, 2025, and appears in the journal's January 8, 2026 issue, Volume 394, Number 2, pages 107–110 [2]. It is indexed in PubMed as PMID 41370797 [1]. PubMed's record carries no abstract [1]. The journal's own abstract states the argument in a single sentence: "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].
The authors are Suhas Gondi, M.D., M.B.A., of the Department of Medicine at Massachusetts General Hospital, 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 in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women's Hospital and Harvard Medical School in Boston [2].
In the piece, the authors argue that generic liraglutide — a GLP-1 medicine now facing generic competition — has been largely overlooked in the debate over GLP-1 spending, and that wider uptake could pull in additional manufacturers and push prices lower, widening access to GLP-1 therapy at a fraction of brand-name prices [2]. The full text is available only to journal subscribers [2]. The article is filed under cost of health care, insurance coverage, Medicare and Medicaid, diabetes, obesity, drugs devices and the FDA, and comparative effectiveness, among other topics [2].
The journal also published an audio interview alongside the piece: a 10-minute-52-second conversation with Rachel Sachs about recent agreements governing coverage and pricing of GLP-1 receptor agonists in the United States [2].
Why it matters for patients
Liraglutide is not semaglutide or tirzepatide. Ozempic, Wegovy and Rybelsus are semaglutide; Mounjaro and Zepbound are tirzepatide. Liraglutide is a separate GLP-1 medicine, and this perspective is about its generic market, not about the drugs many US patients currently take for weight loss or type 2 diabetes [2].
The authors' central claim is about cost, not about how well any drug works: they argue that covering GLP-1 medicines is a fiscal burden, and that a lower-priced generic could ease it [2]. Whether that translates into a lower price at the pharmacy counter depends on how insurers and pharmacy benefit managers design coverage, and the abstract places the choice with patients, clinicians and insurers rather than with manufacturers alone [2].
The perspective runs alongside a companion NEJM article on insurance coverage and pricing of weight-loss drugs in the United States, an indication that the journal is treating GLP-1 affordability as an active policy question [2].
Several practical questions are not answered in what has been published so far. Current list or net prices for generic liraglutide, how many manufacturers sell it, how many US patients have switched to it, and how insurers are covering it have not been reported in these sources.
What happens next
The perspective is already in print: it appeared online December 10, 2025, and in the January 8, 2026 issue of the New England Journal of Medicine [2]. No further actions, studies or policy milestones tied to the article have been disclosed [1][2].
Sources
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