The Biggest GLP-1 Stories of 2025

2025 was the year the GLP-1 story stopped being mostly about clinical trials and became a story about price, supply and power. If you only followed the headlines loosely, here is what actually mattered, roughly in the order it happened.

Nothing here is medical advice. It is a record of what changed.

Why did compounded semaglutide suddenly become a legal problem?

On February 21, 2025 the FDA issued a declaratory order finding the shortage of semaglutide injection products resolved [1]. That sentence sounds administrative. It was not.

A shortage listing is what allows compounding pharmacies to make copies of a drug that is otherwise protected. Semaglutide had been listed since 2022, and an entire telehealth industry grew around compounded versions sold for a fraction of the brand price. When the FDA ended the listing, it gave state-licensed 503A pharmacies until April 22, 2025 and 503B outsourcing facilities until May 22, 2025 to stop making products that were “essentially a copy” of the approved drug [1].

Compounders sued. Patients who had been paying a few hundred dollars a month suddenly faced a choice between a much higher brand price and an uncertain supply. Novo Nordisk later estimated that as many as 1.5 million Americans were still using compounded GLP-1s.

How did drugmakers respond on price?

By becoming retailers. In March, Novo Nordisk launched NovoCare Pharmacy, selling every dose of FDA-approved Wegovy directly to cash-paying patients for $499 a month, against a list price above $1,300 [3]. In August it extended the same $499 price to Ozempic [2]. Eli Lilly had already cut its Zepbound vial prices in February.

Then in November, Novo went further with a limited-time $199 introductory offer for the first fills of lower doses.

None of this touched the list price. It created a parallel cash market that ran alongside insurance, and it set up the bigger pricing change that came in November.

Why did CVS drop Zepbound?

On May 1, Novo Nordisk announced that Wegovy would become the preferred obesity GLP-1 on CVS Caremark’s largest commercial formularies from July 1, with Eli Lilly’s Zepbound excluded [6]. CVS also agreed to sell Wegovy for $499 to cash payers at more than 9,000 stores.

An estimated 200,000 patients had to switch from a drug that was working for them, and a class action followed. The episode was a reminder that in the US market, a pharmacy benefit manager’s spreadsheet can move more prescriptions than a clinical trial.

What happened to WeightWatchers?

It filed for bankruptcy. WW International filed a prepackaged Chapter 11 in Delaware on May 6, 2025, carrying $1.88 billion in liabilities [5]. Subscription revenue had fallen 9.3% in the first quarter while its clinical business, which includes weight-loss medication, grew more than 57%.

The company kept operating and emerged private on June 24 with about $1.15 billion of debt eliminated, then relaunched in December around GLP-1 prescribing. Other wellness companies scrambled to rebuild their offerings around the drugs rather than against them.

Why did Novo Nordisk fire its chief executive?

Because the share price collapsed. On May 16 the board announced that Lars Fruergaard Jorgensen, chief executive since 2017, would step down, citing “recent market challenges, the share price decline, and the wish from the Novo Nordisk Foundation” [4]. Lars Rebien Sorensen, who chairs the Foundation, joined the board as an observer, which turned out to be the first move in a much larger governance shift.

Maziar Mike Doustdar took over in August. Within a month he announced 9,000 job cuts, about 11.5% of the workforce, with roughly 5,000 in Denmark, aiming to save about $1.25 billion a year by the end of 2026 [9]. It was the largest layoff in Danish corporate history.

In October the chair and several independent directors resigned over governance disagreements with the Foundation. At an extraordinary general meeting on November 14, shareholders installed Sorensen as chair. The Foundation holds 77% of voting rights while owning about 28% of the share capital, and some minority investors objected loudly.

Why did Novo Nordisk break up with Hims & Hers?

Novo had signed telehealth companies Hims & Hers, LifeMD and Ro in April to sell branded Wegovy at $499. Eight weeks later, on June 23, it terminated the Hims deal, accusing the company of “illegal mass compounding” under “the false guise of personalization” and of deceptive marketing [7]. Hims shares fell more than 30% in a day.

The fight ran on through the year, with the FDA sending Hims a warning letter in September over claims about its compounded semaglutide products. It was finally settled in March 2026.

What new thing did semaglutide get approved for?

Liver disease. On August 15, 2025 the FDA granted Wegovy accelerated approval to treat noncirrhotic metabolic dysfunction-associated steatohepatitis, or MASH, with moderate to advanced fibrosis [8]. In the ESSENCE trial, 63% of participants on Wegovy had MASH resolution without worsening fibrosis, against 34% on placebo.

It made Wegovy the first GLP-1 with a liver indication, and the only one that still holds it. Accelerated approval means the benefit was shown on a surrogate measure, with a confirmatory trial still running.

Two other label wins followed: Ozempic gained a chronic kidney disease indication in January [2], and Rybelsus gained a cardiovascular indication in October.

What did the White House deal actually change?

On November 6, 2025 the administration announced most-favored-nation pricing agreements with Novo Nordisk and Eli Lilly [10]. The headline numbers:

• Medicare and Medicaid would pay $245 a month for GLP-1 drugs including Ozempic, Wegovy, Mounjaro and Zepbound, with a $50 patient copay
• Cash prices on a new government referral site, TrumpRx, would start near $350 a month for injections and trend toward $245
• Starting doses of the coming oral GLP-1s would be about $149 to $150 a month
• Medicare would cover obesity treatment for the first time

In exchange, both companies got relief from pharmaceutical tariffs, with Lilly exempted for three years, and fast-track regulatory vouchers for future medicines. Novo Nordisk also cut prices on insulins including NovoLog and Tresiba to $35 a month.

Separately, CMS announced negotiated Medicare prices later that month under the Inflation Reduction Act, setting semaglutide at about $274 a month from January 1, 2027, with the figure varying by presentation: $276.78 for an Ozempic 4 mg/3 mL pen or 30 Rybelsus 7 mg tablets, and $385.63 for four Wegovy 2.4 mg pens. Semaglutide had been selected for that negotiation round back in January 2025.

Who won the fight for Metsera?

Pfizer. In one of the strangest corporate weeks of the year, Pfizer and Novo Nordisk traded escalating bids for obesity biotech Metsera, whose lead candidate is a once-monthly injectable GLP-1. Pfizer sued Novo and Metsera in Delaware, the FTC raised concerns about Novo’s deal structure, and on November 8 Metsera accepted a sweetened Pfizer offer worth up to $86.25 a share, about $10 billion [11].

Novo withdrew the next day, saying it would advance its own pipeline. For a company already under pressure, losing a bidding war it had publicly dared its rival to win was not a good look.

What was the year’s biggest scientific disappointment?

Alzheimer’s disease. On November 24, Novo Nordisk reported that the EVOKE and EVOKE+ phase 3 trials, which together enrolled 3,808 adults with mild cognitive impairment or early Alzheimer’s, did not slow disease progression versus placebo [12]. Oral semaglutide moved some disease biomarkers, but that did not translate into any benefit for thinking or daily function.

Novo discontinued the planned one-year extension and ended the program. The shares fell about 8%, a larger reaction than expected for a trial UBS had given only a 10% chance of success.

What ended the year on a high note?

The pill. On December 22, 2025 the FDA approved the Wegovy pill, once-daily oral semaglutide 25 mg, for chronic weight management and to reduce the risk of major cardiovascular events in adults with obesity or overweight and established heart disease [13]. It was the first oral GLP-1 approved anywhere for weight loss.

In the OASIS 4 trial, participants who stayed on treatment lost an average of 16.6% of body weight. The launch came two weeks later at $149 a month for starter doses, and it became one of the fastest US drug launches on record.

Novo also filed CagriSema, its semaglutide-plus-cagrilintide combination, with the FDA on December 18.

What about safety in 2025?

The main development was vision. In June the European Medicines Agency’s safety committee concluded that non-arteritic anterior ischemic optic neuropathy, or NAION, a rare form of sudden vision loss, should be listed as a very rare side effect of Ozempic, Rybelsus and Wegovy [14]. The World Health Organization issued a parallel statement. EMA advised anyone with sudden vision loss or rapidly worsening eyesight to contact a doctor without delay, and said semaglutide should be stopped if NAION is confirmed.

The US label did not follow. In December, a separate federal multidistrict litigation was created for NAION claims, alongside the existing one for gastrointestinal injuries.

What did it all add up to?

By December 2025 semaglutide had a broader label than any competitor, a pill on the way to pharmacies and a government deal guaranteeing Medicare coverage. It also had a new chief executive, a new board, 9,000 fewer employees, a lost bidding war, a failed Alzheimer’s program and a rival outselling it in the United States.

If you are taking or considering any of these medicines, the practical takeaway from 2025 is that what you pay and where you get it changed more than what the drug does. Talk to a healthcare provider about the clinical question, and check your specific plan and pharmacy for the price question, because both keep moving.

Sources

1. Declaratory Order: Resolution of Shortages of Semaglutide Injection Products — FDA
2. Ozempic (semaglutide) FDA Approval History — Drugs.com
3. Wegovy (semaglutide) FDA Approval History — Drugs.com
4. Novo Nordisk ousts CEO after falling behind in weight loss market — Reuters
5. WeightWatchers Files for Bankruptcy Amid Wave of New Weight-Loss Methods — The New York Times
6. In major blow for Lilly, Novo strikes deal giving Wegovy preferred access on CVS Caremark formulary — Fierce Pharma
7. Novo Nordisk terminates collaboration with Hims & Hers Health, Inc. — PR Newswire
8. FDA Approves Treatment for Serious Liver Disease Known as ‘MASH’ — FDA
9. Wegovy-maker Novo Nordisk to cut around 9,000 jobs — CNBC
10. Trump announces deals with Eli Lilly, Novo Nordisk to slash weight loss drug prices — CNBC
11. Pfizer to Acquire Obesity Drug Start-Up Metsera in $10 Billion Deal — The New York Times
12. Novo Nordisk A/S: evoke phase 3 trials did not demonstrate a statistically significant reduction in Alzheimer’s disease progression — GlobeNewswire
13. FDA approves Novo Nordisk’s Wegovy pill — PR Newswire
14. PRAC concludes eye condition NAION is a very rare side effect of semaglutide medicines — European Medicines Agency