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Same molecules, different biology None of these price differences change the compound class doing the work: GLP-1 receptor agonists (semaglutide, liraglutide, dulaglutide) and the dual agonist tirzepatide, evidenced by STEP ( NEJM , 2021), SURMOUNT ( NEJM , 2022), and SURMOUNT-OSA ( NEJM , 2024)
The primary actions of GLP-1 include stimulating insulin secretion from pancreatic beta cells in response to elevated blood glucose (importantly, this insulin release is glucose-dependent, reducing hypoglycaemia risk), suppressing glucagon release (which prevents the liver from producing excess glucose), and slowing gastric emptying
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