Following other expanded indications (opens a new window) for GLP-1s, Wegovy has now received FDA approval for the treatment of metabolic dysfunction-associated steatohepatitis (MASH) in adults with moderate-to-advanced fibrosis. This marks a significant expansion in the therapeutic landscape for GLP-1s, highlighting their growing role in addressing complex metabolic conditions.
The growing GLP-1 approval pipeline has significant implications for employers in terms of cost, coverage, and employee access. Throughout the end of 2026, new indications across a broad range of clinical applications are expected that employers should be aware of, including:
ALZHEIMER’S DISEASE
Semaglutide could become the first GLP-1 drug approved for Alzheimer's disease (AD) by late 2026. The manufacturer may choose to give this semaglutide molecule a unique brand name other than Rybelsus for its use in AD.
CHRONIC WEIGHT MANAGEMENT
Novo Nordisk’s oral semaglutide (which may be marketed as Rybelsus at an anticipated higher dose or rebranded with a new name for weight management use) is pending approval for chronic weight management (CWM) in Q4 of 2025.
A higher dose of Wegovy for CWM is anticipated in late 2026.
Eli Lilly’s new oral orforglipron could be approved for CWM in late 2026.
As the GLP-1 drug class continues expanding there could be eight or more novel GLP-1–based drug approvals for CWM over the next four years.
HEART FAILURE WITH PRESERVED EJECTION FRACTION
Wegovy is pending approval in the second half of 2025 for heart failure with preserved ejection fraction (HFpEF) in adults with obesity.
MAJOR ADVERSE CARDIOVASCULAR EVENT REDUCTION
Rybelsus is pending approval in October 2025 for MACE reduction in adults with T2D.
Expanded indication of Mounjaro for MACE reduction in adults with T2D is anticipated in late 2026.
METABOLIC DYSFUNCTION-ASSOCIATED STEATOHEPATITIS
Wegovy was recently approved to treat metabolic-associated steatohepatitis (MASH) in adults with moderate-to-advanced fibrosis (excessive scar tissue in the liver).
PERIPHERAL ARTERY DISEASE
Ozempic is pending approval in October 2025 for peripheral artery disease (PAD) in adults with T2D.
TYPE 2 DIABETES
Potential approval of high-dose Rybelus is anticipated in late 2026 for T2D.
Eli Lilly’s new oral orforglipron could be approved for T2D in late 2026.
How employers can manage the next phase of GLP-1 expansion
Beyond 2026, GLP-1s are also being explored for their potential in other areas, such as cancer, addiction, and more, with rapidly changing dynamics. As GLP-1-based therapies continue to gain broader indications outside diabetes and obesity, proactive payer management and close monitoring of trends in both utilization and spend will be increasingly important.
Employers should ensure a comprehensive approach that includes supportive lifestyle interventions around diet and exercise, and review formulary, utilization management, and benefit design opportunities to help control costs while ensuring appropriate access that’s informed by the targeted needs of an employee population.
Speak to a Lockton expert to learn how Lockton’s Pharmacy, (opens a new window) Precision Health (opens a new window), and Medical (opens a new window) consulting practices can help you balance access, outcomes, and affordability within a holistic benefits strategy.
