TOPLINE

Generic injectable semaglutide could cost as little as $28 per person-year after the initial patent expired in April 2026 — a fraction of current branded prices — and be available in about 162 countries by the end of 2026, covering roughly 69% of the global type 2 diabetes (T2D) burden and 84% of the clinical obesity burden.

METHODOLOGY

• Semaglutide remains largely unaffordable in many low- and middle-income countries. That scenario could change, with patents expiring in April 2026 in several major manufacturing and market countries, opening the door to generic competition and bulk purchasing deals that could sharply cut prices.
• Using World Bank population data and the World Obesity and Diabetes Atlas, researchers estimated the number of individuals with obesity and T2D in countries where generic semaglutide might become available and separately estimated potential launch prices after patent expiration.
• To track where and when patents expire, the team used a global database of drug patents, cross-checking the results against regional records.
• They then examined 33 shipment records of semaglutide’s active pharmaceutical ingredient, exported to and from India between November 2024 and November 2025, to calculate a weighted mean cost per kilogram.
• Using that trade data, a standard pricing model was built that incorporated active pharmaceutical ingredient costs, formulation, packaging, labor, and transport costs, plus a 27% tax on profit and a 30% profit margin, to project what generic oral and injectable versions might cost once they reach the market.

TAKEAWAY

• Patents set to expire in 2026 in 12 countries account for about 47% of the global obesity burden and 49% of T2D cases; no patent filings were found in 150 additional countries. By the end of 2026, generic injectable semaglutide could be available in 162 countries, covering roughly 69% of T2D and 84% of clinical obesity.
• For treatment-naive patients during the establishment phase, estimated weekly injection costs were $28-$134 per person-year for the 1.7-mg dose and $29-$138 per person-year for the 2.4-mg dose; costs in subsequent maintenance years were nearly identical.
• Oral versions cost more because they require higher doses: Estimated costs were about $186 per person-year for a 7-mg once-daily dose and $344 per person-year for a 14-mg once-daily dose.
• The cost of active ingredients was minimal — a few cents per dose — but disposable injection pens cost $0.30-$2.50 per device, meaning the device alone could cost 8-68 times more than the active drug plus all other production inputs combined.

IN PRACTICE

“Lower prices through generic access could enable earlier intervention for obesity, integration into primary care, and a shift from treating advanced metabolic complications toward preventing long-term morbidity,” the authors of the study wrote.

“Sustainable impact will require coordinated policy approaches that combine equitable medicine pricing, strengthened primary care systems, lifestyle support, and broader public health interventions,” they added.

SOURCE

The study was led by Jacob Levi, NHS Royal Free Hospital Trust, London, England. It was published online as a brief cutting report in Obesity.

LIMITATIONS

Although the analysis used established cost-plus assumptions, actual production costs can vary by manufacturer, scale, and procurement terms. The researchers noted that Indian shipment prices reflected current transactions rather than the lowest costs achievable under high-volume generic production. They also acknowledged that pricing for injection devices was less transparent than that of the active ingredient.

DISCLOSURES

The study was funded by the International Treatment Preparedness Coalition. One author disclosed receiving lecture fees and travel support, grant support, advisory board fees, and provision of drugs from several pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.