As semaglutide drug patent expires today, what to know about weight loss drug availability

Several generic versions of the popular weight loss drug semaglutide are likely to become available Saturday (March 21) onwards, following the expiry of Novo Nordisk’s patent today. Several of India’s top drug manufacturers will launch their products, with as many as 50 brands likely to become available.

The cost is expected to drop by at least a third to a fifth of the existing cost, increasing access to the medication.

What brands will become available?

Several companies have already announced the brands they will launch on Saturday. Take, for example, Natco Pharmaceuticals, which will launch ‘Semanat’ and ‘Semafull’ in 2mg, 4mg, and 8mg doses. The drug will cost R1,290 per month for the lowest dose and R1,750 for the highest one, according to the company. The company will also launch an easy-to-inject pen device next month in the same three doses that will cost Rs 4,000, Rs 4,200, and Rs 4,500 respectively.

To compare, Novo Nordisk’s Ozempic, meant for the treatment of diabetes, costs between Rs 8,800 and Rs 11,175 per month, while its weight loss Wegovy costs between Rs 10,850 and Rs 16,400.

Zydus will market three brands of semaglutide — ‘Semaglyn’, ‘Mashema’, and ‘Alterme’. The company has also entered into agreements with Lupin and Torrent to market its 15mg semaglutide pens as Semanext, Livarise, and Sembolic. Sun Pharma will launch it under the brand name Noveltreat, which will be available in five doses: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg.

These are just some of the brands that will try to capture the lucrative weight loss market in India. The innovator GLP-1 products did not take off as much in India as seen in other countries, with the molecules entering the market only last year.

When and where can I get it?

The generic versions of semaglutide are likely to become available in the market from Saturday onwards. These would be available at the local pharmaceutical stores, which may take a few days depending on supply.

Importantly, these medicines will be dispensed only on the prescription of registered medical practitioners. These cannot be directly purchased over the counter by people.

Who is semaglutide meant for?

The lower dose version of semaglutide is meant for the treatment of type-2 diabetes, along with lifestyle interventions such as diet and exercise.

The higher dose version is meant for those who are obese with a BMI of over 30 or those who are overweight with a BMI of over 27 but have other obesity-related co-morbid conditions such as diabetes, hypertension, or high cholesterol levels. The drug is usually prescribed for those who are struggling to lose weight, even with lifestyle modification, with doctors warning that these interventions need to continue even when a person starts taking semaglutide.

How many people in India are living with obesity?

An estimated 254 million people are living with obesity in India, according to the India study. This number increases to 351 million if abdominal obesity is considered. Abdominal obesity is the accumulation of fat around the waist, which is known to increase the risk of obesity-related conditions more than generalised fat.

The number of adult men living with obesity or being overweight increased from 1.53 crores in 1990 to 8.12 crores in 2021, which is projected to increase to 21.8 crores by 2050, according to a Lancet study. When it comes to adult women who are overweight or obese, the numbers increased from 2.14 crore in 1990 to 9.8 crore in 2021, and are projected to go up to 23.17 crores by 2050.

Concerningly, the number of children who are obese or overweight is also increasing, with the number of overweight or obese boys going up from 0.46 crore in 1990 to 1.33 crore in 2021, which is projected to go up to 1.6 crore in 2050. When it comes to overweight and obese girls, the numbers increased in India from 0.45 crore in 1990 to 1.24 crore in 2021, with the numbers expected to go up to 1.44 crore by 2050.

How have these drugs changed the way obesity is treated?

Obesity is now considered to be “a lifelong, chronic disease that requires holistic care including these therapies, surgeries, and other lifestyle interventions,” according to the recent recommendations from the World Health Organisation, which said these new therapies can be used long-term for the treatment of obesity in adults. The guidelines also urged governments to work towards creating health systems geared towards life-long treatment of obesity by creating systems screening, early diagnosis, referral, maintaining patient registries, and regular follow-up to check progress. This is essentially the model followed for all other chronic diseases.

The new definition for obesity also does away with a simple BMI measurement. A Lancet Commission recently defined pre-clinical and clinical obesity. This considers preclinical obesity as just a physical attribute, but not an illness. It says: “In some people, it might represent an earlier stage of clinical obesity, whereas in other people it can be a phenotype with lower tendency to directly affect organ function.”

Clinical obesity, on the other hand, has been defined as a chronic illness that results in alterations in organ functions regardless of other conditions a person might have. “It can lead to life-altering or life-threatening complications.”

Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government’s management of the Covid-19 pandemic and closely followed the vaccination programme. Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports. Dutt also takes a keen interest in the country’s space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan. She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University’s Dart Centre. Dutt has a Bachelor’s Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times. When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More