Biotech Bulletin: Global Access to Weight Loss Drugs

Blockbuster drugs Wegovy and Ozempic have taken the world by storm, with far-reaching implications for public health, including reduced disease burden, economic benefits and improved mental health. According to the World Obesity Atlas 2023 report, 38% of the global population is currently overweight or obese, and more than half the global population will be living with obesity within 12 years if prevention, treatment and support do not improve.

Ozempic is available in 22 countries, while Wegovy has only been launched in five countries. Neither drug is approved in India, where Indian drugmakers are taking access and affordability into their own hands. Pharma companies including Cipla, Lupin, and Dr. Reddy’s Laboratories and have started developing their own versions of semaglutide, each targeting a slice of the multibillion-dollar obesity market.

Mumbai-based analyst, Vishal Manchanda, said of the generic drugs, “We expect volume expansion to increase multi-fold by the time [Novo Nordisk’s] patent expires, which is a few years from now. They will also be available at a much lower price by generic drugmakers.”

In the meantime, as global drug shortages continue, and Americans face significantly higher prices for much-needed medications for diabetes and weight loss, many have turned to the black market where unregulated online compounding pharmacies offer DIY semaglutide kits.

A Burgeoning Black Market

 Novo Nordisk has not been able to meet the extraordinary demand for Wegovy and Ozempic in spite of taking aggressive measures to capture the booming addressable market for weight loss. The company completed a $16.5 billion acquisition of drug manufacturer Catalent to help boost the supply of Wegovy and Ozempic, it has invested heavily in increasing its production capacity in Denmark, to the tune of $6 billion, and in November 2023, the company stated it will add inhouse fill-finish capacity to increase production of semaglutide.

In August 2023, the Wall Street Journal uncovered a “robust online marketplace” of more than 50 websites selling compounded semaglutide and tirzepatide, the active ingredients on Ozempic, Wegovy, and Mounjaro. Later in 2023, the FDA seized thousands of units of unregulated Ozempic, but despite moves to strengthen its drug supply chain security, counterfeit distributors have become increasingly skilled at making fake medications. The FDA has received a number of adverse event reports detailing the health effects experienced by patients that have been impacted by using compounded semaglutide, and commented in a statement, “Patients should be aware that some products sold as ‘semaglutide’ may not contain the same active ingredient as FDA-approved semaglutide products.”

In India, the wait for brand-name Wegovy is expected to be another two years, according to Novo Nordisk. In December 2023, IndiaMART, an e-commerce platform, partnered with Novo to fight counterfeit Wegovy there, flagging and preventing suspicious or illegal online sales.

Manufacturing a Solution

Indian drugmakers will be ready to release their products to a large and growing market when Novo Nordisk’s patents expire. India, with a population of 1.2 billion people, is believed to have an estimated 350 million people living with obesity. As these pharmaceutical companies enter the market with their semaglutide alternatives, they could potentially offer more affordable alternatives, making weight loss treatments accessible to a wider population worldwide.

The emergence of Indian alternatives to Ozempic and Wegovy signifies a paradigm shift in the weight loss pharmaceutical industry, with implications for both domestic and global markets.

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Biotech Bulletin: Global Access to Weight Loss Drugs

Catie Corcoran

Biotech Editor