MDrugs that enable dramatic weight loss will experience a new boom in use, according to experts, as the first generic versions hit the market this week at a lower cost than the original drugs.
The injections, called ‘skinny jabs’ by the media, can help people lose more than 10% of their body weight and have become extremely popular in recent years, with celebrities praising its effects.
These include Wegovy 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 a weight loss aid. All four mimic a gut hormone called GLP-1 and are produced by the Danish pharmaceutical company Novo Nordisk.
It announced on Tuesday it would invest more than $4 billion (£3.2 billion) in US factories producing the injectable drugs to try to meet growing demand.
Although 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.
Patents for both Victoza and Saxenda have expired, according to Novo Nordisk. As a result, other drug manufacturers are working on generic versions. Israel Teva pharmaceutical industry The world’s largest generic drug maker launched a generic version of Victoza in the US on Monday.
The move comes days after the US regulator, the Food and Drug Administration, provisionally approved the generic version of Victoza from London-based Hikma Pharmaceuticals.
They are not the only ones: among others are reportedly planning to launch their own generic liraglutide products (the active ingredient in Victoza and Saxenda). Pfizer, Mylan from Viatris and Sandoz from Novartis.
Such drugs are cheaper than the originals. According to Teva, the wholesale acquisition cost (WAC) of its new generic product will be 13.6% lower than Victoza’s, at $469.60 for the two-pack and $704.40 for the three-pack.
“WAC prices do not take into account the price discounts offered to customers and do not reflect our final net price,” a company spokesperson said.
But this is just the beginning: Ozempic and Wegovy will both 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 will lead to a further boom in use – especially in lower-income countries. “Rich people will always want the shinier new drugs,” he said, adding that newer drugs are likely to have fewer side effects.
Mark Samuels, the 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 the patented drug is often prohibitive for the NHS, so it is prescribed sparingly by doctors. However, the onset of generic competition is likely to reduce the price significantly, and this means the NHS can afford to treat more patients. This has a wider health benefit for the population as greater access to these medicines will reduce the crippling pressure that obesity-related conditions place on NHS resources.”
In Britain, generic competition typically reduces prices paid by the NHS by as much as 80% to 90% after losing exclusivity, the BGMA said.
Dr. Simon Cork of Anglia Ruskin University said competition in the form of new medicines will also play a big role in any future price fixing for the medicines that currently exist. Eli Lilly’s diabetes drug Mounjaro has just been approved for obesity in Britain and is still being developed. another weight loss drug, Retatrutide.
“Competition will, I suspect, reduce the cost of these drugs, especially since the drugs that come to market often show more favorable weight loss benefits than semaglutide,” he said.
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Victoza generated sales of £245 million for Novo Nordisk in the first three months of this year, down 23% from a year earlier, while Saxenda’s sales halved to £188 million in the first quarter. Last year, Victoza achieved sales of £982 million, down 30% from 2022, while Saxenda posted sales of £1.2 billion, down 4%.
The Association of the British Pharmaceutical Industry has defended the use of patents as essential for healthcare breakthroughs.
Claire Machin, executive director of international policy and UK competitiveness at the industry body, said drug development is a high-risk process, with the average cost of the journey from discovery to launch reaching $2.3 billion last year.
“For every 10,000 compounds tested, only one or two will successfully pass all stages of research, development and clinical trials to become licensed medicines available to patients,” she said. “A strong intellectual property framework enables the development of advanced medicines and supports future innovation.”
Although generic forms of Victoza will be released this month, Yeo said the big turning point will be when semaglutide – the active ingredient in both Ozempic and Wegovy – can be made generic. “Then a powerful medicine will be available to the vast majority of the world, which would be great,” he said.
Cork said any reduction in costs was welcome, not least because currently GLP-1 analogues can only be prescribed by the NHS to eligible patients for two years. “This was introduced in no small part because of the questionable cost-effectiveness of its continued use,” he said.
“A reduction in costs would shift the balance of this cost-effectiveness, potentially paving the way for longer-term use – especially when combined with research demonstrating reversal of weight loss after the patient stops taking it, and the continued benefit on the field of cardiovascular risks. associated with long-term use.”
Dr. Ivan Koychev of the University of Oxford, who is researching the use of GLP-1 analogues in dementia patients, said demand for such drugs currently exceeds supply due to the high prevalence of obesity and type 2 diabetes.
“This is evidenced by members of the public purchasing these drugs online or attempting to recreate the drugs themselves,” he said.
While it is unclear how widespread the practice is, internet forums including Reddit have numerous examples of people reporting injecting themselves with such “DIY” preparations.
However, experts have warned that the approach is dangerous because some people are using unlicensed versions of semaglutide ultimately require emergency hospital care after purchasing from unregulated online sellers without a prescription.
Yeo added that the availability of cheaper generic versions of drugs such as semaglutide could help tackle the problem. “Becoming a generic product would make its supply much more secure as it would undermine the hidden market for the product,” Yeo said. “We will also have a lot more information about the long-term safety profile, which can only be a good thing.”