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This is a valid concern, and it is indeed possible that these drugs stay expensive for the next couple years due Eli Lilly and Novo Nordisks duopoly, but I think to underestimate the impact they will have because of any delay is short sighted

Dahl K, et al

Dipeptidyl peptidase-4 inhibitor Inhibitors of dipeptidyl peptidase 4 ( DPP-4 inhibitors or gliptins ) are a class of oral hypoglycemics that block the enzyme dipeptidyl peptidase-4 (DPP-4)

Michigan Department of Health and Human Services contracts with Blue Cross Blue Shield of Michigan and other organizations, each with their own requirements

Long-acting GLP1 agonists should be discontinued for at least 1 week before the procedure (listed in Table 5)
