MDrugs that enable drastic weight loss are likely to experience a new boom, experts say, as the first generics hit the market this week at a lower price than the original drugs.
Dubbed “slimming shots” in the media, these injections can help people lose over 10 percent of their body weight. They have become extremely popular in recent years and are being endorsed by celebrities.
These include Wegovy and Saxenda, which are approved for weight loss, and Ozempic and Victoza, which are approved for type 2 diabetes but are often prescribed “off-label” as weight loss agents. All four mimic a gut hormone called GLP-1 and are manufactured by Danish pharmaceutical company Novo Nordisk.
On Tuesday, the company announced it would invest more than $4 billion (£3.2 billion) in US factories to produce the injectable drugs to meet booming demand.
While such treatments are available to some patients through the NHS, private access is expensive and recent shortages have made them difficult to obtain. But change is on the horizon.
According to Novo Nordisk, the patents for Victoza and Saxenda have expired. As a result, other pharmaceutical companies are working on generics. Israel’s Teva Pharmaceutical Industries, the world’s largest generic drug maker, launched a generic version of Victoza in the United States on Monday.
This move came days after the U.S. Food and Drug Administration granted provisional approval to London-based Hikma Pharmaceuticals’ generic drug Victoza.
They are not the only ones: Other companies reportedly planning to launch their own generic versions of liraglutide (the active ingredient in Victoza and Saxenda) include Pfizer, Viatris’ Mylan and Novartis’ Sandoz.
Such drugs are cheaper than the originals. According to Teva, the wholesale cost (WAC) of its new generic will be 13.6% lower than Victoza, at $469.60 for a two-pack and $704.40 for a three-pack.
“WAC prices do not take into account discounts offered to customers and do not reflect our final net price,” a company spokesman said.
However, this is just the beginning, as both Ozempic and Wegovy will lose their patent protection in China in 2026, in Europe and Japan in 2031, and in the US in 2032.
Professor Giles Yeo of Cambridge University said generics will lead to another boom – especially in low-income countries. “Rich people will always want the better new drugs,” he said, adding that newer drugs are likely to have fewer side effects.
Mark Samuels, chief executive of the British Generic Manufacturers Association (BGMA), described the first wave of generic weight-loss drugs as a “potentially transformative opportunity for public health”.
“The current market is largely private and driven by patients paying for their medicines themselves,” he said. “The cost of patented medicines is often prohibitive for the NHS, so doctors prescribe them sparingly. However, the onset of competition from generics is likely to bring the price down significantly, and that means the NHS can afford to treat more patients. This has an overall benefit for population health, as better access to these medicines will reduce the crippling burden on NHS resources from obesity-related disease.”
In the UK, according to the BGMA, competition from generics typically leads to price reductions in the NHS of up to 80 to 90 percent when exclusivity is lost.
Dr Simon Cork of Anglia Ruskin University said competition in the form of new drugs will also play a big role in future pricing arrangements for the drugs already in place. Eli Lilly’s diabetes drug Mounjaro has just been approved in the UK to treat obesity and the company is currently developing another weight-loss drug, retatrutide.
“Competition, in my opinion, will drive down the cost of these drugs, especially since the drugs coming to market often have more favorable weight loss than semaglutide,” he said.
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Victoza generated revenue of £245 million for Novo Nordisk in the first three months of this year, down 23 percent from a year earlier, while Saxenda’s revenue halved to £188 million in the first quarter. Last year, Victoza generated revenue of £982 million, down 30 percent from 2022, while Saxenda reported revenue of £1.2 billion, down 4 percent.
The British Pharmaceutical Industry Association defended the use of patents, arguing that they were crucial to groundbreaking advances in healthcare.
Claire Machin, executive director of the industry association for international policy and UK competitiveness, said drug development was a high-risk process, with the average cost of developing a drug from discovery to market last year being $2.3 billion.
“Out of 10,000 compounds tested, only one or two successfully complete all stages of research and development and clinical trials and become approved medicines for patients,” she said. “A strong intellectual property framework enables the development of cutting-edge medicines and supports future innovation.”
While generic versions of Victoza will hit the market this month, Yeo said the big turning point will come when semaglutide – the active ingredient in Ozempic and Wegovy – can be made generic. “Then much of the world would have an effective medicine available, which would be great,” he said.
Cork said any reduction in costs would be welcomed, not least because GLP-1 analogues can currently only be prescribed on the NHS to eligible patients for two years’ use. “This has been introduced not least because the cost-effectiveness of their continued use is questionable,” he said.
“Reducing the cost would shift the cost-benefit ratio and potentially pave the way for longer-term use – especially when coupled with research showing reversal of weight loss after the patient stops taking the medication and sustained benefit in reducing cardiovascular risk with longer-term use.”
Dr Ivan Koychev of Oxford University is researching the use of GLP-1 analogues in dementia patients. He said demand for such drugs currently exceeds supply because obesity and type 2 diabetes are widespread.
“This is evidenced by citizens purchasing these drugs online or attempting to manufacture them themselves,” he said.
While it is unclear how widespread this practice is, there are numerous examples on internet forums such as Reddit of people reporting that they have injected themselves with such “DIY” preparations.
However, experts warn that this approach is dangerous because some people taking unapproved versions of semaglutide may end up requiring emergency hospital treatment because they bought the drug without a prescription from unregulated online retailers.
Yeo said the availability of cheaper generics of drugs such as semaglutide could help solve the problem. “The introduction of a generic would make supply much more certain as it would erode the hidden market for the product,” Yeo said. “We will also have much more information about its long-term safety profile, which can only be a good thing.”