The European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) recommended against approving Eli Lilly’s tirzepatide (Mounjaro) for a heart‑failure indication while supporting approval of Novo Nordisk’s semaglutide (Kayshild) for liver disease, according to regulatory coverage. The split decision reflects divergent assessments of the available trial data and underscores continued scrutiny of incretin‑based therapies outside obesity and diabetes. CHMP’s opposition to Mounjaro in heart failure will influence Lilly’s regulatory strategy in Europe and may affect ongoing trials and label discussions; the committee’s backing of semaglutide in liver disease (Kayshild) opens a new non‑metabolic indication pathway for GLP‑1 agents and will affect market positioning and payer negotiations across hepatology and metabolic care.