Photo: EPA
The simultaneous expiration of patent protection for semaglutide — the active ingredient in Ozempic — in the world’s two most populous countries is paving the way for low-cost versions of a drug that has transformed the treatment of obesity and diabetes.
Ozempic, an injectable semaglutide-based medication, first entered the market in 2018 as a treatment for type 2 diabetes. It later became a global phenomenon after demonstrating remarkable effectiveness in weight loss. Now, with patent protection for the drug’s active ingredient expiring simultaneously in China and India, the market for metabolic disease treatments is on the brink of a major shift, Bloomberg reports.
What is Ozempic
Semaglutide is a synthetic analogue of the natural hormone GLP-1 (glucagon-like peptide-1), which regulates appetite and blood sugar levels. Drugs based on it — Ozempic and Wegovy, both produced by the Danish company Novo Nordisk — have fundamentally changed how obesity is perceived. The medical community increasingly treats it as a chronic disease rather than a matter of willpower.
Until now, these breakthrough treatments have largely been accessible only to wealthier patients. In Western countries, prices can reach hundreds of dollars per month. Even though Novo Nordisk has reduced the price of Wegovy in China and India ahead of patent expiry, the drug remains unaffordable for most people in those countries.
Market scale
The numbers are striking. According to the medical journal The Lancet, five years ago China had 402 million people living with obesity. By 2050, that figure is projected to rise by 56%, approaching half of the country’s population. In India, 180 million people were affected by obesity in 2021, and that number is expected to exceed 450 million within 25 years.
Obesity significantly increases the risk of a range of serious conditions, including:
- type 2 diabetes
- coronary heart disease
- hypertension
- stroke
- other chronic illnesses
Most diabetes patients in these countries are still treated with older, less effective drugs. According to GlobalData analyst Nadeem Anwar, switching to generic semaglutide could significantly improve glucose and weight control while reducing long-term complications. Increased competition could drive prices down to around $50 per month, compared to hundreds of dollars in Western markets.
Six months to market
In China, more than 10 companies — including CSPC Pharmaceutical Group and Huisheng Biopharmaceutical — are already developing generic versions of the drug. Local media reports suggest that these products could reach the market in about six months. India is also ожидає dozens of generics within the next few months.
It is worth noting that semaglutide’s patent has already expired in Canada, and will soon expire in Brazil and Turkey. If Chinese and Indian manufacturers obtain regulatory approval, they could become major players in those markets as well. China is already the world’s largest supplier of active pharmaceutical ingredients (APIs), giving its companies a natural advantage across the production chain.
China already leads
More broadly, China dominates not only in manufacturing but also in research. Over 100 GLP-1 drugs are currently in development there — about 40% of the global total, according to Citeline’s Pharmaprojects. Over the past two years, most global licensing deals in the GLP-1 space — both by value and volume — have involved Chinese-origin drugs.
Notably, even U.S. pharmaceutical giant Pfizer, after years of unsuccessful attempts to develop its own obesity drug, ultimately licensed a Chinese-developed candidate. This underscores China’s transformation from a manufacturing hub into a source of pharmaceutical innovation.
Over the past five years, Chinese pharma companies have shifted their model from copying drugs to developing original therapies and signing multi-billion-dollar licensing deals with global reach. This is happening against the backdrop of a looming “revenue cliff” for major players like Novo Nordisk and Eli Lilly, as patent protections on blockbuster drugs begin to expire.
Risks and caveats
Despite the transformative potential, generics are not a silver bullet. GLP-1 drugs come with a range of risks and complexities:
- Muscle loss: improper use may lead to loss of muscle mass, causing weakness and fatigue
- Malnutrition risk: reduced appetite can result in insufficient nutrient intake without proper dietary support
- Mental health concerns: questions remain about potential links to depressive symptoms
According to Johanna Ralston, CEO of the World Obesity Federation, countries need to invest in training healthcare professionals for long-term patient management, as well as in prevention — promoting physical activity and healthy diets. Overburdened and underfunded healthcare systems in China and India may struggle to deliver such comprehensive care.
The future of Novo Nordisk and Eli Lilly
The emergence of low-cost generics will directly impact the revenues of first movers. Novo Nordisk and Eli Lilly, which have effectively dominated the GLP-1 market, now face competition not only from each other but also from dozens of Asian manufacturers capable of producing the same molecule at significantly lower cost.
At the same time, the overall market is set to expand dramatically. Billions of people who previously could not afford treatment may gain access. This means that even with lower unit prices, total market volume could grow enough to accommodate many players. The key question is who will secure regulatory approvals first and build reliable supply chains.
