What to Watch Next in GLP-1 News

Most coverage of weight-loss drugs looks backward. This page looks forward. Below are the specific decisions, readouts, court dates and price changes scheduled or expected between now and 2028, with the caveat that expected dates slip all the time.

Everything here is a description of what is scheduled or anticipated. None of it is medical advice, and an expected approval is not an approval.

Which FDA decisions are pending right now?

As of September 2026, four GLP-1 decisions are in the queue [1]:

CagriSema for weight management, expected around December 2026. Novo Nordisk’s once-weekly combination of semaglutide and the amylin analog cagrilintide was filed in December 2025 on the strength of REDEFINE 1 and REDEFINE 2. Approval would make it the first GLP-1 and amylin combination cleared for obesity. This is the biggest single catalyst left in Novo’s year.

Mounjaro for cardiovascular risk reduction, expected in the third quarter of 2026. Eli Lilly’s filing rests on the SURPASS-CVOT trial, which showed an 8% reduction in major adverse cardiovascular events compared with dulaglutide and met non-inferiority rather than superiority [1]. Tirzepatide is a different molecule from semaglutide and this would be its own indication.

Foundayo for type 2 diabetes, expected in the fourth quarter of 2026. Lilly filed orforglipron for diabetes in the second quarter of 2026 under the same priority voucher pilot that sped its obesity approval.

Ozempic 25 mg tablets for type 2 diabetes, expected in 2026. Novo filed a supplemental application for a higher tablet strength. Current Ozempic tablets top out at 9 mg.

There is also a fifth filing without a public timeline: Novo submitted the Wegovy 25 mg tablet for MASH in the second quarter of 2026 [1]. A decision could come in 2026 or early 2027.

What should you expect from CagriSema, realistically?

Lower expectations than the hype suggested two years ago. CagriSema has produced real weight loss, around 22.7% in REDEFINE 1 and 23% in the open-label REDEFINE 4 trial, but it has repeatedly fallen short of the bar set for it [3]. REDEFINE 4 failed to show non-inferiority against tirzepatide 15 mg in February 2026, and REIMAGINE 4 missed its dual primary endpoint on blood sugar in August.

Novo has said a trial exploring CagriSema 2.4/2.4 mg’s full weight-loss potential, REDEFINE 11, will report in the first half of 2027, and that a higher-dose trial combining 2.4 mg and 7.2 mg would begin in the second half of 2026 [3].

If the FDA approves CagriSema in December, the questions that matter for patients will be the label’s wording, the price and whether payers put it on formulary, not the headline percentage.

What is coming after CagriSema?

Two Novo Nordisk candidates and one very large rival.

Amycretin, now also called zenagamtide. This is a single molecule that activates both GLP-1 and amylin receptors. Phase 2 data showed about 22% weight loss over 36 weeks with the weekly injection and around 13% over 12 weeks with the oral form, in both cases without a clear plateau. Both formulations moved into phase 3 during 2026 [13]. Any filing is years away.

Retatrutide, Eli Lilly’s triple hormone agonist. In the phase 3 TRIUMPH-1 trial reported in May 2026, participants on the 12 mg dose who stayed on treatment lost an average of 28.3% of body weight over 80 weeks, the largest late-stage obesity result on record; counting everyone randomized regardless of adherence, the average was 25.0% [7]. Two more trials succeeded in July, and Lilly said in August that the data package is complete and it plans to file in the first quarter of 2027 for obesity, obstructive sleep apnea and knee osteoarthritis pain [2].

There is a legal wrinkle worth watching. Lilly wants to file retatrutide as a biologic, which would carry twelve years of exclusivity instead of five. The FDA determined that it is neither a protein nor a biological product, a district court vacated that determination, and and oral argument before the Seventh Circuit in Eli Lilly and Company v. Robert F. Kennedy, Jr. is scheduled for September 24, 2026 — as of September 14 it had not yet been heard [2][14] (updated 2026-09-14). The outcome affects how long the drug stays off-limits to copies.

Everything else. Amgen’s monthly MariTide is in a phase 3 program spanning weight management, diabetes, cardiovascular outcomes, heart failure and sleep apnea. Boehringer Ingelheim has survodutide, Zealand Pharma and Roche have the amylin analog petrelintide, AstraZeneca has moved elecoglipron into phase 3, Structure Therapeutics has begun dosing in its oral aleniglipron program, and Pfizer is running more than 20 obesity trials including a monthly injection from the Metsera platform [10]. IQVIA counts roughly 190 obesity-related products in development.

What happens to prices on January 1, 2027?

Two changes land on the same day.

First, Novo Nordisk’s US list price for Wegovy injection and tablets, Ozempic injection and Rybelsus tablets falls to $675 a month, a cut of about 50% for Wegovy and 35% for Ozempic [4]. List price is what drives your share of cost if you are in a high-deductible or coinsurance plan.

Second, the Medicare negotiated price for semaglutide takes effect under the Inflation Reduction Act, at about $274 a month, with the exact figure varying by presentation [5]. CMS estimates aggregate Part D out-of-pocket savings of roughly $685 million in 2027 across all 15 drugs in that negotiation round, though what any individual saves varies enormously.

The practical point is simple: costs for semaglutide products are likely to change in January 2027, in either direction, so it is worth rechecking what you actually pay then rather than assuming.

When does Medicare coverage change again?

The Medicare GLP-1 Bridge, which began July 1, 2026, is currently scheduled to end on December 31, 2027 [6]. It covers Wegovy injections and tablets, Foundayo tablets and the Zepbound KwikPen at a flat $50 monthly copay for eligible Part D enrollees who meet the clinical criteria.

What replaces it is unclear. The broader BALANCE model, which would have run through Part D plans into 2031 and covered a wider drug list, was delayed indefinitely in 2026 after insurer pushback. Watch for CMS guidance during 2027, and expect the question of permanent Medicare obesity coverage to become a legislative fight rather than a regulatory one.

What safety questions are still open?

The US NAION label. European, UK, WHO and Australian regulators have all acted on the link between semaglutide and non-arteritic anterior ischemic optic neuropathy, a rare form of sudden vision loss [12]. The EMA classifies it as a very rare side effect. As of the May 2026 revision, the US Ozempic label did not carry that warning. Whether the FDA follows is an open question, and it is central to the vision-loss lawsuits.

Muscle and bone. Lean mass accounts for roughly 25% to 40% of the weight lost on GLP-1 drugs, broadly similar in proportion to lifestyle interventions but larger in absolute terms because the total loss is larger [1]. Trials have not answered what that means for muscle strength, physical function or long-term outcomes, especially in older adults. Drugs designed to preserve muscle during treatment are in early testing.

Long-term use. Most pivotal trials ran 68 to 84 weeks. Real-world persistence, what happens when people stop, and outcomes over five or ten years are still being assembled.

If you have specific concerns in any of these areas, they are worth raising with a healthcare provider rather than resolving from a news article.

What is happening in the courts?

Two federal multidistrict litigations sit before the same judge in the Eastern District of Pennsylvania. MDL 3094 covers gastrointestinal injuries including gastroparesis, ileus and obstruction and had 4,022 cases pending in September 2026, per a litigation tracker following the Judicial Panel on Multidistrict Litigation’s monthly statistics; the JPML’s own August 1, 2026 report put the figure at 3,928. MDL 3163 covers NAION vision-loss claims and had about 200 [9].

No case has been tried and no settlement has been announced. A hearing on the admissibility of the plaintiffs’ expert evidence was scheduled for mid-September 2026, and those rulings decide what scientific testimony reaches a jury. Bellwether trials have been described as possible in late 2026 at the earliest, with large settlements considered unlikely before late 2027.

Treat any headline promising a settlement amount with suspicion. There isn’t one.

Could semaglutide reach younger children?

It is on the table. In September 2026 Novo Nordisk reported that in the STEP Young trial, 40.4% of children aged 6 to under 12 with obesity were no longer classified as having obesity after 68 weeks, assuming full adherence, against none on placebo, and that no safety concerns were identified for growth or pubertal development [8]. The trial enrolled 165 children. Full data are due at ObesityWeek 2026 in Washington, DC on November 14 to 17.

A label expansion would need its own FDA review. Wegovy has been approved for ages 12 and older since December 2022, so the question is whether the age floor moves, not whether pediatric use is new.

What about generics and the patent cliff?

Semaglutide lost exclusivity in eight markets during 2026: Canada, Brazil, China, India, Mexico, Turkey, Saudi Arabia and South Africa [11]. Generics launched quickly in India at steep discounts, though Bloomberg reported in August that they had not displaced branded products as fast as expected.

The United States is a different story. US protection runs to roughly 2032, and Europe is in a similar window. Analysts point out that semaglutide accounted for about 75% of Novo Nordisk’s 2026 sales, which is why everything in this article about CagriSema, amycretin and the oral franchise matters so much to the company.

How should you follow this without drowning in headlines?

A few habits help.

Check the date on anything you read. This market changes monthly, and a page written in 2024 about shortages or compounding is now wrong.

Check which drug is being discussed. Semaglutide, tirzepatide, orforglipron and retatrutide are four different molecules with different results, different labels and different manufacturers. Headlines conflate them constantly.

Check whether a number describes everyone in a trial or only the people who stayed on treatment. Companies report both, and the difference is often several percentage points.

And check the source. An FDA press announcement, a CMS coverage page or a journal paper says something different from a law firm’s marketing page or a market-research forecast.

Sources

1. GLP-1 Pipeline Update: August 2026 — Prime Therapeutics
2. Obesity Drug News: GLP-1 Readouts and Approval Watch — Life Science Daily News
3. Novo Nordisk Form 6-K: REDEFINE 4 headline results — U.S. Securities and Exchange Commission
4. Novo Nordisk announces significant reduction in US list price for Wegovy, Ozempic, and Rybelsus — PR Newswire
5. Beyond the Numbers: Insights From the 2027 Medicare Drug Price Negotiation Cycle — Health Affairs
6. Medicare GLP-1 Bridge — CMS
7. Lilly’s triple agonist, retatrutide, delivered powerful weight loss in pivotal Phase 3 obesity trial — Eli Lilly and Company
8. Novo Nordisk says semaglutide cut obesity rates in young children in trial — Reuters
9. MDL 3094: Glucagon-Like Peptide-1 Receptor Agonists — MDL Update
10. Obesity Drug Pipeline 2026: Companies, Targets & Trials — Ozmosi
11. Your Questions Answered: Off-patent Semaglutide in 2026 — IQVIA
12. PRAC concludes eye condition NAION is a very rare side effect of semaglutide medicines — European Medicines Agency
13. Novo’s GLP-1/Amylin Dual Agonist Amycretin to Enter Late-Stage Trials for Obesity — Patient Care Online
14. Can a new weight loss treatment escape the legal and regulatory thicket? — Reason, September 10, 2026