Weight loss drug supply races

Everyone in pharmaceuticals wants a piece of the action when it comes to weight-loss drugs. In the US, manufacturers Novo Nordisk and Eli Lilly have convinced regulators that they can now supply enough of their respective injection products semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound) to end official shortages. That has left compounding pharmacies, which for more than two years have been plugging the supply gap with their own formulations, fighting for their rights to continue selling these lucrative medicines.

Meanwhile, various generics companies are preparing for impending expiry of patents on Novo Nordisk’s semaglutide. The medicine’s primary patents are due to expire in Canada, China, India and Brazil in 2026, and in other markets between 2028 and 2032. The US, probably the most profitable market for these treatments, has the longest patent protection in place. However, several generics manufacturers are aiming to challenge Novo’s patents to bring their versions to market sooner. Novo has already struck an agreement in a dispute over Ozempic patents with Viatris-subsidiary Mylan and Indian contract manufacturer Natco Pharma, which will likely give the Mylan-Natco partnership an advantage when it comes to introducing semaglutide generics in the US market. How generics will fare in the face of President Trump’s threatened import tariffs remains to be seen – especially since (as Novo and Lilly’s efforts have shown), building new capacity for injector pens is neither cheap nor fast.

US patents on Lilly’s tirzepatide extend until at least 2036, and even further in other territories, although it’s likely that once cheaper semaglutide generics become available, Lilly will need to lower prices of its drugs anyway, to remain competitive.

All that means the hunt is on for the next wave of even more effective therapies. And while some are focusing on enhancing glucagon-like peptide 1 (GLP-1) mimics, others are looking into related metabolic pathways, with various deals being struck as companies look for footholds in the space. In December, Merck & Co licensed a GLP-1 drug from Chinese biotech Hansoh. Meanwhile, Roche has agreed a $1.6 billion (£1.2 billion) licensing deal with Danish firm Zealand for petrelintide – an amylin mimic that helps people feel fuller for longer. Roche intends to develop the drug both as a standalone treatment and in combination with other drugs, and has promised Zealand up to a further $3.6 billion in performance-based payments if the drug succeeds.

Novo’s own combination effort, CagriSema (which combines semaglutide with cagrilintide, a mimic of both amylin and calcitonin) has produced slightly disappointing results in clinical trials. While patients lost significant amounts of weight, they didn’t lose significantly more than on semaglutide alone. Those results are unlikely to deter others – with a huge range of options to explore, from complementary combinations to formulations that last longer, or can be taken in tablet form rather than injection, there is still plenty of appetite within industry to invest in these drugs.