New evidence underscores both clinical promise and economic friction for GLP-1 therapies. A meta-analysis of randomized trials found higher-dose oral orforglipron (36 mg maintenance) produced greater weight and metabolic improvements than 12 mg, with comparable safety outcomes. At the same time, a separate payer-cost study examined how manufacturer coupons affect spending across patients and payers during GLP-1 treatment episodes in the U.S., framing copay offsets as a key factor in real-world cost distribution. Together, the findings show the category’s dual challenge: optimizing dose strategies for outcomes while managing downstream reimbursement design and affordability dynamics that can influence access and net costs.