Oral GLP-1 Pipeline Signals Potential Cost Declines: Eric Levin

As more oral glucagon-like peptide-1 (GLP-1) medications enter the market, patients and employers may begin to see meaningful shifts in access and affordability, according to Eric Levin, CEO and cofounder of Scripta.

The first oral GLP-1 has already launched, though Levin noted in an interview with The American Journal of Managed Care^® that it is currently priced similarly to injectable versions when covered by insurance. However, additional oral competitors are expected within the next 18 months—a development that could put downward pressure on prices. “Competition does tend to change these things,” Levin said, adding that increased market entrants typically lead to more aggressive pricing, particularly in the pharmacy benefit space.

Policy changes could also influence costs. Levin pointed to discussions around expanding GLP-1 coverage in Medicare and Medicaid, an idea floated in policy circles, including in President Donald Trump’s TrumpRx proposals. If federal programs were to cover these medications more broadly, the resulting increase in demand and government-negotiated purchasing could drive prices lower. While no changes have been finalized, expanded public coverage would significantly reshape the market.

Over the long term, Levin expects oral GLP-1s to gain favor over injectables. Most patients prefer pills to injections, and oral formulations eliminate the need for cold-chain storage and transport. If oral options become dominant, economies of scale could further reduce costs.

Still, Levin cautioned that lower production costs do not automatically translate to lower prices. Demand for GLP-1s remains extraordinarily high, and manufacturers may seek to maintain premium pricing while the market can bear it. Even so, many clinicians predict that GLP-1s could follow a trajectory similar to statins, with widespread prescription within 5 to 10 years due to their broad metabolic and cardiovascular benefits. If that occurs, sustained competition and market expansion may ultimately make these therapies more affordable and accessible.

“Once that happens,” Levin said, “prices should come down, because otherwise the market won't be able to bear it.”