Mdrugs that enable dramatic weight loss are likely to experience a new boom, experts said, as the first generic versions hit the market this week at a lower price than the original drugs.
Dubbed “skinny punches” by the media, the injections can help people lose more than 10% of their body weight and have become very popular in recent years, with celebrities praising their effects.
These include Wego and Saxenda, which are licensed for weight loss, and Ozempic and Victoza, which are licensed for type 2 diabetes but are often prescribed “off-label” as weight loss aids. All four mimic a gut hormone called GLP-1 and are manufactured by the Danish pharmaceutical company Novo Nordisk.
It announced on Tuesday that it would invest more than $4bn (£3.2bn) in US plants to make injectable drugs to try to meet rising demand.
While such treatments are available to some patients on the NHS, private access is expensive and recent shortages have made them difficult to obtain. But change is coming.
The patents for Victoza and Saxenda have expired, according to Novo Nordisk. As a result, other drugmakers are working on generic versions. Israel’s Teva Pharmaceutical Industries, the world’s largest generic drug maker, launched a generic version of Victoza in the US on Monday.
The move comes days after the U.S. regulator, the Food and Drug Administration, tentatively approved a generic version of Victoza from Hikma Pharmaceuticals in London.
They’re not alone: Pfizer, Viatris’ Mylan and Novartis’ Sandoz are among others reportedly planning to launch their own generic liraglutide products (the active ingredient in Victoza and Saxenda).
Such drugs are cheaper than the originals. According to Teva, the wholesale acquisition cost (WAC) of its new generic will be 13.6% less than the price of Victoza, at $469.60 for a two-pack and $704.40 for a three-pack.
“The WAC price does not take into account price discounts offered to customers and does not reflect our final net price,” a company spokesperson said.
But that’s just the beginning, Ozempic and Wego will lose patent protection in China in 2026, in Europe and Japan in 2031, and in the US in 2032.
Professor Giles Yeo, from the University of Cambridge, said generic versions would lead to further growth in use – particularly in lower-income countries. “Rich people will always want the flashier 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 through self-pay patients,” he said. “The cost of a patent medicine is often prohibitive for the NHS, so doctors have been sparingly prescribing it. However, the advent of generic competition is likely to bring the price down significantly, meaning the NHS can afford to treat more patients. This has wider population health benefits, as greater access to these medicines will reduce the crippling burden obesity-related conditions have on NHS resources.”
In the UK, generic competition typically reduces prices paid by the NHS by up to 80% to 90% after exclusivity is lost, according to the BGMA.
Dr Simon Cork, of Anglia Ruskin University, said competition in the form of new drugs would also play a big role in future pricing arrangements for those that exist now. Eli Lilly’s diabetes drug Mounjaro has just been approved for the treatment of obesity in the UK, and it is developing another weight loss drug, Retatrutide.
“I suspect competition will drive down the cost of these drugs, especially since the drugs coming to market often show more favorable weight loss than semaglutide,” he said.
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Victoza generated £245m in sales for Novo Nordisk in the first three months of this year, down 23% on a year earlier, while Saxenda’s first-quarter sales halved to £188m. Last year, Victoza had sales of £982m, down 30% from 2022, while Saxenda posted sales of £1.2bn, down 4%.
The Association of the British Pharmaceutical Industry has defended the use of patents as essential to health discoveries.
Claire Machin, the UK’s executive director for international policy and competitiveness, said drug development was a high-risk process, with the average cost of getting a drug from discovery to launch last year at $2.3 billion.
“For every 10,000 compounds tested, only one or two successfully make it through all stages of research and development and clinical trials to become licensed medicines available to patients,” she said. “A strong intellectual property framework enables the development of cutting-edge medicines and supports future innovation.”
While generic forms of Victoza are emerging this month, Yeo said the big break will be when semaglutide — the active ingredient in Ozempic and Wegovy — can be made as a generic. “A powerful drug will then be available to the vast majority of the world, which would be wonderful,” he said.
Cork said any cost reduction was to be welcomed, not least because currently GLP-1 analogues can only be prescribed for use for two years on the NHS for eligible patients. “This was introduced in no small part because of the questionable cost-effectiveness of their continued use,” he said.
“Cost reductions would shift the balance of this cost-effectiveness, potentially paving the way for their longer-term use – especially when coupled with research showing reversal of weight loss after a patient stops taking them and continued benefit in cardiovascular risk. associated with long-term use.”
Dr Ivan Koychev of the University of Oxford, who is researching the application of GLP-1 analogues in dementia patients, said demand for such drugs currently outstrips supply due to the high prevalence of obesity and type 2 diabetes.
“This is evidenced by members of the public obtaining these drugs online or attempting to reconstitute the drugs themselves,” he said.
While it’s unclear how widespread the practice is, internet forums including Reddit have numerous examples of people reporting self-injecting such “DIY” preparations.
But experts have warned that this approach is dangerous, as some people taking unlicensed versions of semaglutide end up needing emergency hospital care after buying from unregulated online sellers without a prescription.
Yeo said the availability of cheaper generic versions of drugs such as semaglutide could help solve the problem. “Becoming a generic will make its supply much safer because it would undermine the hidden market for the product,” Yeo said. “We’ll also have a lot more information about its long-term safety profile, which can only be a good thing.”