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In the 25 years I have spent watching how new health technologies travel through the global system, they have followed a predictable route. There is one tier for wealthy populations whose chronic diseases are treated with the best available medicine. The other is for everyone else: they are told to manage with whatever their underfunded health system can afford.
The latest example is a new class of injectable drugs that are better known by their brand names – Ozempic, Wegovy, and Mounjaro, or by the shorthand GLP-1, which refers to the hormone they mimic.
These drugs mimic the hormone the body produces to regulate appetite and blood sugar, resulting in significant weight loss and improved metabolic health.
They have transformed how wealthy countries treat obesity and are moving through the global system faster than most new health technologies. But the two-tier pattern is following close behind.
The intellectual property situation is changing rapidly.
The patent on semaglutide – the active molecule in Ozempic and Wegovy – has already expired in India, Brazil, China, Canada, and Turkey, covering roughly 40% of the world’s population. This means manufacturers in those countries can now produce their own versions without paying licensing fees to the original developer.
One analysis estimates the cost of producing a generic injectable version could be...