GLP-1 Research Cycle Summary — May 24, 2026

This research cycle tracked the continued evolution of the GLP-1 and obesity space, focusing on milestone clinical approvals, a major federal Medicare policy shift, next-generation competitive pipelines, and the ripple effects on medical devices.

1. Medicare GLP-1 Bridge Extended to 2027 & BALANCE Delayed

On April 21, 2026, CMS announced a major policy shift: it delayed the Part D portion of the permanent BALANCE Model (originally slated for 2027) due to a lack of historical claims data and severe pricing uncertainties for Part D plan bids (due June 1, 2026). To maintain coverage, CMS extended the temporary Medicare GLP-1 Bridge program through December 31, 2027. This program bypasses traditional Part D plans via a "single central processor" (BIN/PCN 028918 MEDDGLP1BR), providing eligible seniors with Wegovy and Zepbound for a flat $50 copay (which does not count toward the Part D OOP cap), while capping net manufacturer prices at $245/month.

2. Milestone Approvals: Orforglipron (Foundayo™) and Wegovy HD

The spring of 2026 brought major drug approvals:

• Foundayo™ (orforglipron): Approved on April 1, 2026, as the first daily oral nonpeptide GLP-1 for weight loss (12.4% weight loss in ATTAIN-1). It has no food or water restrictions.
• Wegovy HD (7.2 mg): Approved on March 19, 2026, demonstrating 20.7% weight loss in the STEP UP trial.
• Ozempic Oral Tablets: Oral semaglutide (formerly Rybelsus) was rebranded as Ozempic tablets with improved bioavailability, launching on May 4, 2026.

3. Next-Gen Competitors: Viking and Roche Phase 2 Success

• Viking's Oral VK2735: At ECO 2026 on May 12, 2026, Viking presented Phase 2 oral data showing a mean weight loss of 12.2% (10.9% placebo-adjusted) at 13 weeks with no plateau, planning Phase 3 trials later this year.
• Roche's CT-388: In January 2026, Roche announced that its weekly SC dual agonist CT-388 achieved a 22.5% placebo-adjusted weight loss at 48 weeks, with 54% of patients resolving their obesity. Phase 3 trials are starting in Q1 2026.

4. Ripple Effects: Bariatric Surgery Volumes Decline

A landmark study published in JAMA Network Open by Mass General Brigham/Harvard researchers quantified the surgical shift. As GLP-1 prescriptions surged 105.7% between 2022 and 2023, metabolic bariatric surgery rates declined by 8.7%. This highlights a growing pharmacological preference, though less than 6% of eligible patients with obesity received either treatment, indicating massive remaining market headroom.

Related Findings

• The Rise of Oral Obesity Pills and the Expanded Medicare GLP-1 Bridge Program — Detail on approvals and CMS policy shifts.
• Next-Gen Incretin Challengers: Viking's Oral VK2735 and Roche's CT-388 Phase 2 Results — Deep dive into competitive assets.
• The Ripple Effect on Medical Devices: Bariatric Surgery Declines Amid GLP-1 Surge — Detailed surgical volume analysis.