CMS data shows liraglutide brand spending collapsed in the first generic year

Federal spending data published by the Centers for Medicare & Medicaid Services show what happened when the first GLP-1 medicine lost exclusivity: brand spending on liraglutide fell sharply in 2024, while generic versions picked up only a fraction of the dollars.

In Medicare Part D, the two Victoza package sizes together accounted for about $1.32 billion in 2023 — $1.005 billion for the Victoza 3-Pak and $317.2 million for the 2-Pak.^[1] In 2024 that combined total dropped to roughly $280.9 million, split between $203.1 million for the 3-Pak and $77.8 million for the 2-Pak.^[1] Generic liraglutide, which appears in the file for the first time in 2024, accounted for $48.1 million.^[1]

Prices per unit dropped, and so did patient counts

The data also show price movement, not just volume shifts. Average Part D spending per dosage unit for the Victoza 3-Pak fell 32.1%, from $126.95 in 2023 to $86.21 in 2024; for the 2-Pak it fell 27.8%, from $126.64 to $91.45.^[1] Generic liraglutide averaged $75.15 per dosage unit in Part D in 2024.^[1]

Fewer people filled the brand. Part D beneficiaries using the Victoza 3-Pak dropped from 142,213 in 2023 to 62,754 in 2024, and 2-Pak users fell from 83,777 to 41,126.^[1] Generic liraglutide reached 24,405 beneficiaries across 62,254 claims.^[1] Two manufacturers appear in the generic listing — Teva Pharmaceuticals, with $48.06 million of the total, and Hikma Pharmaceuticals, with $34,084.^[1]

Medicaid shows the same pattern, including Saxenda

Medicaid drug spending files tell a similar story. Saxenda, the higher-dose liraglutide approved for weight management, fell from $129.5 million in 2023 to $38.4 million in 2024, with claims dropping from 107,319 to 33,533.^[2] Victoza spending in Medicaid fell from about $585.0 million in 2023 ($387.0 million for the 3-Pak and $198.0 million for the 2-Pak) to about $225.6 million in 2024 ($148.3 million and $77.3 million).^[2] Generic liraglutide recorded $31.0 million and 53,174 Medicaid claims in 2024, at an average of $73.81 per dosage unit and $582.44 per claim.^[2]

One caveat sits inside the Medicaid file itself: for Saxenda, the reported change in average spending per dosage unit from 2023 to 2024 is listed as +0.77% in the "Overall" row but −3.49% in the Novo Nordisk manufacturer row, so the two entries disagree.^[2] The Hikma generic row in Medicaid is also flagged as an outlier for 2024.^[2] The fields released cover total spending, dosage units, claims and — in Part D — beneficiary counts; rebate amounts are not among the published fields, so these totals should not be read as net payments.^[1][2]

Why it matters for patients

Liraglutide is the only GLP-1 drug with a US generic so far, which makes 2024 the first real test of what generic competition does to this class. The numbers suggest two things happened at once: some prescribing moved to generics, and the brand's per-unit price came down as well.^[1]

But the shift was not one-for-one. Combined Part D spending on brand and generic liraglutide in 2024 — roughly $329 million — was far below the $1.32 billion spent on Victoza alone in 2023, and beneficiary counts for the brand fell by more than half.^[1] That is consistent with people leaving liraglutide entirely, not only switching to a cheaper version of it. The files do not say where those patients went, so that part is not yet known from this data.

For anyone currently covered for liraglutide, the practical takeaway is that plan economics around this molecule changed quickly once generics arrived, which can affect formulary tiers, prior authorization rules and copays. Whether the same pattern will repeat for semaglutide or tirzepatide is not addressed in these files.

What happens next

The 2024 figures are the most recent full year in the CMS Part D and Medicaid spending datasets as published.^[1][2] A 2025 update would show whether generic liraglutide's share keeps growing, whether more manufacturers beyond Teva and Hikma appear, and whether per-unit prices keep falling. No release date for that update is given in these files.