Novo Nordisk's Canadian Mistake

285 pointsposted 8 hours ago
by jbm

139 Comments

jzebedee

7 hours ago

> Prof. Michael Hoffman from Toronto put me on to the Canadian Patent Database, where you can find that Novo did file a patent there for semaglutide. . .but the last time they paid the annual maintenance fee on it was 2018!

> You can even find a letter where their lawyers send a refund request for the 2017 maintenance fee ($250) because Novo apparently wanted some more time to see if they wanted to pay it.

> On the same date in 2019, the office sent a letter saying that “The fee payable to maintain the rights accorded by the above patent was not received by the prescribed due date. . .”

> By that time it was $450 with the late fee added, but that was apparently too much for Novo. They had a one year grace period to make it up, and apparently never did, so their patent lapsed in Canada. And as the Canadian authorities remind them, “Once a patent has lapsed it cannot be revived”.

Impressive failure for "the second-largest semaglutide market in the world."

0cf8612b2e1e

7 hours ago

I always wonder-in this case of such an epic company fuck up, does anyone ever get fired? Or is responsibility so diffuse that nobody is ultimately responsible?

Pharma companies are really nothing more than holders of time-limited, expensive, exclusive IP. The number one priority should be to maintain those protections as long as possible. How could any patent be allowed to lapse, even if there was limited commercial value, let alone, a blockbuster drug making billions?

bawolff

6 hours ago

Typically when people get fired for something like this they are just the scapegoat.

A failure like this isn't just one dude forgetting, its a system failure where policies and checks failed. If it is solely up to one person that is a failure in and of itself.

nextos

5 hours ago

Some people, including legal experts, claim it could have been intentional: https://www.legal.io/articles/5691258/Novo-Nordisk-Lets-Cana....

I was surprised Science didn't discuss this option. However, reader comments in Science do comment on this possibility.

The idea is that letting the patent lapse would avoid getting regulated by the Patented Medicine Prices Review Board.

I know several people working at NN, and it's quite chaotic and political, so I wouldn't rule out an internal oversight.

nl

a minute ago

I'm having trouble understanding the argument outlined in the legal.io link:

> Nordisk has rejected any suggestion that the loss of its Canadian semaglutide patent was a simple mistake. In a statement cited by Fortune, the company stressed that its intellectual property strategy is “carefully considered at a global level,” indicating intentionality rather than a blunder.

> Legal analysts believe the decision was deliberate. Steven Shape, IP Chair at Omnus Law, noted that the annual $250–$450 fee was negligible compared to the looming expiration of both data exclusivity and patent protection in January 2026. Shape argued the lapse was likely “a clear decision by Novo,” not an error.

> That interpretation is bolstered by the company’s simultaneous filing of a Certificate of Supplementary Protection (CSP) in Canada, suggesting Novo valued extended market exclusivity beyond the patent’s life. But because the underlying patent lapsed early, the CSP cannot take effect.

If the interpretation is bolstered by the company’s filing for CSP, but they were ineligible for CSP because they let the patent expire doesn't that imply it was an error?

I'd never heard of CSPs before, but https://en.wikipedia.org/wiki/Supplementary_protection_certi... has some details. They seem to be a patent extension in all but name.

wasabi991011

3 hours ago

Just FYI, this isn't "by Science", it's by Derek Lowe, this is his blog, which is hosted on Science>Commentary>Blogs. In its description, Lowe says it is "editorially independent".

bawolff

4 hours ago

Given how much of a blockbuster drug it is, wouldn't it be worth it for generics to rerun the trials in this specific case?

aspenmayer

4 hours ago

> If it is solely up to one person that is a failure in and of itself.

I would agree. The so-called bus factor has been common knowledge in the industries in question for literal decades now.

https://en.wikipedia.org/wiki/Bus_factor

> An early instance of this sort of query was when Michael McLay publicly asked, in 1994, what would happen to the Python language if Guido van Rossum were to be hit by a bus.

http://legacy.python.org/search/hypermail/python-1994q2/1040...

nextos

4 hours ago

The process for the patent to lapse in Canada is quite long, and you get warning letters once deadlines are close.

There is also a possibility of a paying a late fee and, finally, there is also a reinstatement process.

NN could have missed all these, but they would have to be a really dysfunctional organization. Definitely not a low bus-factor situation.

aspenmayer

4 hours ago

I wasn’t casting aspersions on NN, but jumping off from the allusion that was made by the user who I replied to.

I don’t know what kind of sequence of events could lead to this outcome at NN, but perhaps they were hoist by their own petard. I’m reminded of the “money on the ground” joke involving two economists, which is semi-famous in these parts.

To wit:

> Economist 1: Look, there’s $20 on the ground!

> Economist 2: No there isn’t. If there were, someone would have picked it up already.

https://slatestarcodex.com/2014/06/19/money-on-the-ground/

https://news.ycombinator.com/item?id=28029044

Perhaps the folks at NN are so busy picking up (billions of) dollars that they neglect the dimes on the ground that it would cost to comply with these seemingly trivial, even menial functional requirements of keeping their money printer running.

I’m honestly as befuddled by this brouhaha as anyone. This is a monumental failure of multiple entire business units to perform the core competencies of their jobs. That said, I could honestly believe that the number of people whose job it is (or perhaps was) to worry about the patent expiry at all, let alone be aware of the repeated communiques from the Canadian patent office, is quite low. I would further believe that the accountability dodging has only just begun behind closed doors, if the internal game of megacorporate musical chairs hasn’t already concluded well before this news broke and reached the shores of HN.

Marsymars

3 hours ago

Even at large corps, it's fairly common to outsource IP work to law firms that specialize in IP - and if you're Danish, it might make sense to outsource to a Danish law firm that has its own worldwide IP contacts (rather than getting your own worldwide branch offices to handle local IP laws everywhere). One of said contacts might then pawn off the work onto a junior, who then has their assistant handle all communiques from CIPO. Said assistant could then entirely drop the ball.

I've zero idea about anything specific to Novo Nordisk, but have enough exposure to IP in Canada to envision the above happening in other cases.

nijuashi

2 hours ago

Saying pharma companies are just holders of ‘expensive, time-limited IP’ is not only wrong, it’s offensive to those of us who actually do the science. We spend years designing, testing, and validating drugs, not scheming to hike prices. We’re not all Shkrelis out here.

cperciva

2 minutes ago

I may be wrong, but aren't most drugs sold by large pharma companies actually developed elsewhere and then acquired?

0cf8612b2e1e

35 minutes ago

I was a bench scientist (proteomics) in pharma for over a decade. There is plenty of sweat and blood going into the pipeline, but a company is ultimately defined by the strength of its (patent) portfolio. Which is why a patent cliff drives their valuations.

foofoo12

5 hours ago

> Or is responsibility so diffuse that nobody is ultimately responsible

It doesn't take a very large company for this to happen. I've seen it in a sub 50 person company. There is a task to be done but no one can do it because everyone involved is waiting for someone else to do something. It's like a Mexican standoff.

userbinator

7 hours ago

Or is responsibility so diffuse that nobody is ultimately responsible?

That's exactly how things like this happen. No one has responsibility, thinking it's someone else's problem, so no one bothers to do the needful.

JumpCrisscross

6 hours ago

> thinking it's someone else's problem, so no one bothers to do the needful

Or it’s in someone’s political interest to let the fuckup play out.

ionwake

7 hours ago

after working in many companies for decades I can guarantee that the person responsible is some middle manager, who will just blame one of her/his workers who had that piece of work "deprioritised" to instead focus on the styling of a spreadsheet. The paper trail will point to the manager, who will just claim it was allocated to a problem character.

The cartharsis comes in knowing that them firing the innocent just keeps them repeating the mistake.

hibikir

2 hours ago

In your typical large company, there's always enough nebulous process as to minimize personal accountability for any decision that is made. There might be a decision maker in practice, but there will be enough wide meetings and committees so that the groups as a whole can make bad decision, or a very immoral decisions, with minimal risk of consequences for anyone involved. Raising tough questions in those rooms is a good way to not make friends, and end up isolated in an unimportant position after the next semi-anual reorg.

Even in companies with a strong CEO who is, in fact, lording over everyone, mechanisms will be built to make sure said CEO's bad decisions were group decisions, and that most of the people around him agreed.

Rebelgecko

4 hours ago

Is this the patent equivalent of letting your website's cert expire?

crummy

4 hours ago

More like letting the domain expire, and someone else snapping it up before you can renew.

benrawk

an hour ago

I mean the CEO got fired…

gpt5

7 hours ago

Canadian manufacturers (Sandoz and Apotex) are preparing to launch their own generic versions in early 2026.

I bet many Americans would travel to Canada to buy it there (despite the legality concerns). The medications lasts 2 years in a refrigerator.

rootusrootus

7 hours ago

If you're going to go for a two year supply, it's probably better to just risk shipping it. You're not going to come home with that much without it getting confiscated, and you're way more likely to be searched individually than a typical package is.

c2h5oh

6 hours ago

With de minimis for US-bound packages suspended I suspect way more packages are inspected than used to be.

JumpCrisscross

5 hours ago

> With de minimis for US-bound packages suspended I suspect way more packages are inspected than used to be

But a smaller fraction.

If you’re paranoid, route it via the UAE. All my European and Indian shippers are doing that for tariff-free pricing. (Personal stuff. I’ll pay a customs duty if I get it, of course.)

CamperBob2

4 hours ago

You can import from UAE without paying any duties or fees?

JumpCrisscross

3 hours ago

At least for wine, furniture, cheese, olive oil, art, kitchen equipment and medicine, at least from Italy and Germany and India and Taiwan, in the last six months, allegedly.

delfinom

3 hours ago

I mean that entire region has bought the president, even got themselves a military base being built on American land now too.

So why not.

bparsons

2 hours ago

Higher enforcement demands probably lead to more stuff slipping through.

themafia

7 hours ago

You should be able to travel with a 90 day supply without issue.

daniel_iversen

6 hours ago

Not an American but there’s only very limited circumstances you can travel across the border home to the USA with foreign prescription drugs, right? And this scenario wouldn’t cover it. Unless you just meant they won’t get caught or maybe not fined or confiscated in practice? :)

toomuchtodo

6 hours ago

valicord

5 hours ago

That's mainly for visitors. If you're a US resident, you can't just buy medicines abroad, unless of course we are talking about the "they won’t get caught" scenario.

chronos00

5 hours ago

US residents can buy medicines abroad the FDA link says personal importation is allowed as long as the medicines are FDA approved and are not being imported for commercial purposes. Now in the context of the original post maybe generic versions of Ozempic won't technically be FDA approved yet if the company that produces it has to wait for the US patent to expire.

jay_kyburz

3 hours ago

The FDA approved version may be significantly cheaper to compete with the generic brands.

I also wonder if only the "active ingredients" need to be FDA approved, and the packaging is irrelevant?

Muromec

5 hours ago

Sounds like an opportunity for non-residents.

loeg

41 minutes ago

I think the biggest legality concern is having your shipment seized at the border. Maybe a risk but it’s not exactly a scheduled drug.

stevehawk

6 hours ago

the shelf life is probably longer than that if you buy it in dehydrated form and don't hydrate it (but i have no idea)

greycol

5 hours ago

While I'm all for saving costs, I would be shocked if mixing your own inject-able medicine either weekly (with the chance of making a mistake in dosage or sterility) or too such a high degree of sterility that you can confidentally store several doses is not worth the $200 return flight every two years. Maybe I'm overestimating the risks but it still seems like a small saving for it.

Realistically the cost of semiglutide in generic form means you could fly return every 90 days (personal import restriction for perscription meds) and still save $1000 every 3 months (3x$500 monthly - return flight - generic cost).

choilive

5 hours ago

Its remarkably straightforward. Not fool-proof, but easy. Bacteriostatic water, single use needles/syringes, and self healing injection port vials makes it simple to maintain sterility throughout the process.

Multiple doses can be mixed and stored in the fridge for 4-6 weeks.

kimos

4 hours ago

While I agree and this all seems reasonable, I think you give the average person far too much credit.

stevehawk

3 hours ago

it's extremely common. everyone i know that's on a glp-1 does it this way. that way you can buy it in bulk for a discount. i buy mine roughly 35 weeks worth of doses at a time.

SoftTalker

4 hours ago

This is commonly done for injectable fertility treatments, though in my experience they are hydrated just before use.

gus_massa

5 hours ago

I guess you get more shelf life, but it's an injectable drug.

You probably have to disolve it in very clean water in a very clean container. Do you have to match the salinity and pH with the proprties of the blood? How much time must you stir it to ensure it's completely disolved? Do you have to add something to increase/reduce viscosity? Some alcohol in case there are a few bacterias or improve solubility? How long does the small homemade batch last in the fridge?

IIUC there is another version in pills, they may have a longer shelf life, or not. But ask a medical doctor before taking a ramdom medicine.

stevehawk

5 hours ago

Bacteriostatic water is widely available and you hydrate it in the container it comes in. Its pretty easy. I promise you you probably know someone on a glp-1 that is already doing this.

gus_massa

an hour ago

I found it in a mainstream site here. 30ml for $300, with free shipping for next Wednesday. It has classified as a "nutricional supplement" for bodybuilders. I didn't purchase it, but I guess now I'm in yet another list.

ReptileMan

5 hours ago

So cocaine from the south, ozempic from the north, fetanyl from the west and the meth is homegrown. So USA just need some powder from europe to close the circle.

OptionOfT

4 hours ago

That would be MDMA.

fragmede

18 minutes ago

Wait, but where does Elon's ketamine come from?

reaperducer

5 hours ago

I bet many Americans would travel to Canada to buy it there

Why travel? There are thousands of ads on TV, radio, and the internet each day for Canadian pharmacies that promise to ship whatever you need to the U.S.

AnimalMuppet

7 hours ago

Um, what are the legality concerns? Is it illegal to bring medicine for your own use over the border? If not that, then what?

(Honest question. I don't know.)

jacobgorm

6 hours ago

Just don’t do it in a speed boat.

ChrisMarshallNY

7 hours ago

I totally believe this happened.

If anyone has worked in a big, hidebound corporation, they are familiar with the "That's not my job" quandary.

general1465

6 hours ago

This is impressive feat of bean counting. To save few thousand dollars, they lost market of few billion dollars. Good job.

duxup

5 hours ago

That letter from lawyers probably cost more than 250 …

abirch

5 hours ago

The sad thing is they probably were billed 500 dollars for the lawyers to “read” it.

duxup

5 hours ago

I have an acquaintance working big law. They said the billing was "more offensive thank you could possibly imagine" ... but they took the money of course.

eulgro

7 hours ago

To be honest, given the efficiency of the drug and the huge benefit it could be to society, I feel like if I had been the employee in charge of filing patents I would've more than ready to lose my job in exchange for low cost general availability in the US via (illegal maybe, whatever) cross-border market. It's a nice loop hole and a great thing that once the delay expired they can't file ever again.

One's got to find ways to feel like the good guy when working for Big Pharma . That's probably not what happened but it's nice imagining it.

Vinnl

7 hours ago

Maybe they'd even do it in exchange for just low-cost general availability in Canada!

rahimnathwani

7 hours ago

AIUI, because they let the patent expire, the drug was not subject to price regulation by the government. So they could charge whatever.

And during most of that time, they were still protected by 'data exclusivity' which means that any generic producer could not get approved without doing their own clinical trials, until 8 years had passed.

So they gave up some period of exclusivity in return for being able to charge a higher price when they still had a monopoly.

dghlsakjg

4 hours ago

The price in Canada is ~$175 USD month for name brand Ozempic where I am with no coupons, or other discounts. I see prices in the US around $800+/month.

That is significantly cheaper than the US, and cheaper than other GLP-1 class drugs up here, arguably reasonable. Is the supposition that they would have been forced to charge even less? If so, why are their competitors who kept their patents not charging more?

Counterpoint: Mounjaro/Tirzepatide did keep their patent protection. They are able to, and do, charge significantly more.

loeg

39 minutes ago

The US price for name brand is around $500/mo. More than $175, but not $800.

kristianp

2 hours ago

Does the government/medical insurance subsidise that price though?

beached_whale

an hour ago

No, with drug patents the price is the average of a basket of similar countries, including the US. There is bulk buying for some medications by governments, but it depends.

Most people are using private drug insurance in Canada.

SoftTalker

3 hours ago

Everyone I know taking these is buying generic compounded formulas. Insurance mostly doesn’t cover it so the go for the cheaper options.

dghlsakjg

3 hours ago

That doesn't figure into the pricing strategy or giving away patent protection in Canada in 2018 as far as I can tell?

Compounding isn't allowed in Canada, currently, so I assume you are talking about the US? Compounding Ozempic in the US wasn't a thing in 2018 when this patent was released in Canada, so not sure what one has to do with the other.

What are you getting at in reference to the argument that the patent was released intentionally in order to charge a higher price?

wasabi991011

3 hours ago

> Compounding isn't allowed in Canada

I'm not sure why you think that, compounding is allowed, I live right be a compounding pharmacy. And confirmed it's legal through google.

SoftTalker

3 hours ago

Yes I’m in the USA. I just mentioned that because nobody I know is paying $800/mo. They are buying compounded injections online.

fragmede

15 minutes ago

roughly how much are they paying, then?

Marsymars

3 hours ago

> Compounding isn't allowed in Canada, currently

How does this work? Why/when would compounding not be allowed?

chronos00

4 hours ago

Seems like a plausible explanation, the government should reform the price regulation laws to avoid this endrun around price controls.

llm_nerd

3 hours ago

>And during most of that time

Most of what time? The patent just expired a few months ago. Generics are now ramping up because the patent expired, not because of some hypothetical eight year clinical trials. And for that matter, generics of existing ingredients and dosages do not have to repeat clinical trials anyways, which is one of the big reasons generics are a lot less expensive.

This hypothesis seems retconned and completely at odds with the actual facts. Not least that there has been absolutely nothing exceptional about the pricing of their product in Canada, which has always been one of the cheaper pricings worldwide.

aardvarkr

3 hours ago

This article is saying that the patent elapsed in 2018 because thy didn’t pay the $250 to renew the patent. Instead they relied on “data exclusivity” which means their trial data is exclusively theirs and anyone who wants to sell in Canada must first run safety trials of their own at a huge expense. It’s just as good as a patent but has a shorter window of exclusivity.

numpad0

an hour ago

> Instead they relied on “data exclusivity” which means their trial data is exclusively theirs and anyone who wants to sell in Canada must first run safety trials of their own at a huge expense.

Sounds like potentially a good thing?

enslavedrobot

38 minutes ago

Fun fact: Novo Nordisk's first success was selling insulin, which was discovered in Canada and licensed by the Scientists who's discovered it for free to the danish company in exchange for a promise to use the revenues "for good purposes".

Hopefully this patent SNAFU makes up for 1% of that monumental screw job.

vitorgrs

7 hours ago

In Brazil it will expire in July 2026. It's pretty relevant as it's kinda already announced they will put the generics on the public health care (SUS) for free... Which is big deal as an Ozempic shot costs almost the same as the minimum wage.

This year they already did an analysis to include Ozempic, but it was denied, probably because of the cost difference...

But they were trying on justice to extend the patent...

matheusmoreira

2 hours ago

SUS doesn't have a good track record when it comes to offering modern drugs and treatments. It takes years if not decades for medications to be covered, even when generics are available. Patients often had to go to court with documents from their doctor in order to make things happen. I've lost count of how many patients I've helped get their treatments... And now the supreme court has closed the door on them.

Still, after dapagliflozin I'm ready to believe it. There's also the fact semaglutide will straight up win votes for politicians that provide it.

I expect it to mirror the evolution of dapagliflozin in SUS: it will be offered unconditionally at first, then as they start to feel the weight of the costs involved they'll start imposing conditions and forcing patients to go through endless bureaucracy to get their medication. Age requirements, comorbity requirements, obnoxious paperwork that "justifies" the need for such a drug. Oh I'll gladly fill out those forms...

chrisweekly

2 hours ago

"same as the minimum wage"

... an hour's wage? a week? a month? annual?

tredre3

34 minutes ago

From context it was clear to me that they meant the entire income.

Minimum wage in brazil is 280/month. I don't know how much of it would be taken by taxes, but even if it's 0 then ozempic in Brazil still costs almost 70% of that amount each month.

1oooqooq

3 hours ago

being free means taxpayers will pay. and being on the public system means it will be prescribed only for health risk, just like plastic surgery already is. you don't see people getting nose jobs just because.

aardvarkr

2 hours ago

Generics are so cheap and easy to make that they can reasonably justify that it will save the government money by making the population healthier. Just think about how much less heart disease and cancer and every other obesity-affected disease costs the taxpayer.

UltraSane

2 hours ago

Why wouldn't it be prescribed to morbidly obese people?

dmix

4 hours ago

This is great news for Canadian public/private healthcare insurance. Not only do the drugs cost less but people get healthier and use less services

alister

6 hours ago

> Interviewer at Endpoints: You plan to potentially launch a generic GLP-1 in Canada and Brazil in 2026.

Looking at the original interview on Endpoints, Sandoz CEO Richard Saynor says this about Brazil:

In Brazil, the biggest prescribers are dentists. Everyone says, “Why dentists?” They do aesthetic work, and then you have your Botox, and then you want a bikini body. It’s behaving like an OTC consumer brand. Imagine selling this, rather than $300, at $50. Anybody over the age of 40 in Brazil will probably want to be on that.

But he doesn't explain how they got around the patents. Another comment on HN says they expire in July 2026, but can anyone explain why the patents expire so soon in Brazil?

abirch

5 hours ago

1. In the USA people use compounding companies to get around patents.

2. https://www.reuters.com/business/healthcare-pharmaceuticals/...

giarc

4 hours ago

I think that loophole has closed. If I recall correctly, compounding pharmacies were only allowed to do that as the US gov put the drug on a special list due to shortages. I believe they have removed it from this list (or will do shortly) and that pipeline will stop.

pedalpete

7 hours ago

I thought I had a decent handle on patent law, but maybe I'm missing something here.

Yes, the patent won't be valid for Canada, but you can't import a product into the US which would infringe on a US patent.

So, though there may be a small amount that would slip through the cracks, it isn't as if anyone in the US can now manufacture Semaglutide and distribute it.

Canada is such a small market, that many companies don't bother. Though, for the cost, it seems ridiculous a company as big as Novo didn't pay the $500...that may even have been in Canadian dollars. :)

killingtime74

7 hours ago

Don't worry about the law think about the practical impact. It's now completely legal to ignore the patent in Canada so the price in Canada will plummet.

Canadian pharmacies can legally sell it and Americans (and all other foreigners for that matter) traveling there can legally buy it.

Unlike the criminal law, Novo nordisk would have to go after every single person individually and make the case that they are infringing the American patent. This is all without the help of the police or customs, as a private civil matter.

Obviously this would be uneconomic for Novo Nordisk. You can't search anyone as you don't have any warrants, as it's not a crime and then even if you could, you need to prove that the drugs they have on them were purchased in Canada.

Foreigners who currently pay a huge amount of money would only have to make one trip to Canada in however long period it takes for the drugs to expire. I know I would certainly make a day trip if I was using this drug.

Intellectual property law firms offer services to renew and watch registrations like this worldwide and it would have been very simple to have a contract with one of them.

labcomputer

5 hours ago

> Unlike the criminal law, Novo nordisk would have to go after every single person individually and make the case that they are infringing the American patent. This is all without the help of the police or customs, as a private civil matter.

I don't think that's quite right. One of the things that CBP does is inspect incoming shipments, and confiscate IP-infringing things.

Think about the recent Apple Watch SpO2 sensor patent shenanigans: The threat was to have CBP confiscate any infringing devices at the port of entry. I also remember that multimeters infringing on Fluke's ~~design patent~~ trademark have been blocked at the port of entry:

https://hackaday.com/2014/03/19/multimeters-without-a-countr...

barbazoo

3 hours ago

How practical is that for something the size of a couple pill bottles? Is that something customs would actually catch at all? They seem to have other priorities these days it seems.

wpm

2 hours ago

Even worse, the bottles are minuscule. Each dose is dissolved in like half a mL of bacteriostatic water/saline. You could fit a years supply in 25mL, or 5 tsp.

tavavex

6 hours ago

> Canadian pharmacies can legally sell it and Americans (and all other foreigners for that matter) traveling there can legally buy it.

Well, about that... Aren't all variants of medications like these prescription-only? And in Canada you can't fill a foreign prescription without having a local doctor sign off on it, as far as I know.

JumpCrisscross

5 hours ago

> you can't fill a foreign prescription without having a local doctor sign off on it

This is how medical tourism typically works.

sbrother

3 hours ago

Is that process that can happen online? Or does it require the patient being physically present in Canada?

barbazoo

3 hours ago

Can be done virtually but you might have to use a VPN or even lie about your place of residence.

Marsymars

3 hours ago

Depends on province. From my best reading, pharmacists in Alberta with prescribing authority can directly prescribe all schedule 1 drugs themselves.

petesergeant

3 hours ago

Plenty of countries where having a doctor in the pharmacy is common practice. Buy some retail space in YYZ and you're set...

maximus_01

7 hours ago

Not that small. High income and roughly the same population as California, which isn't too small for companies to bother selling into.

Ozempic did about US$2bn of revenue in 2024 in Canada.

aardvarkr

2 hours ago

Medical tourism is a huge industry. A 3 month supply costs more than $3k in the USA. A flight to Canada costs $300 and takes a few hours of your time. I’d definitely do it if I was taking the drug.

rootusrootus

7 hours ago

As Derek mentions, Canada is the second largest market. There may be a lot coming into the US already, legal or not.

digianarchist

7 hours ago

$450 CAD I believe.

US consumers would have to travel to Canada for injections which isn't practical unless you live on a border town.

It's unlikely to meet the bar for personal importation as you say.

That probably won't stop people from trying. There's already a huge market for illegal compounds and GPL-1 drugs are available alongside the usual testosterone and other steroids.

rootusrootus

7 hours ago

If you have a prescription from a provider in Canada, the limit for personal use is 90 days. As long as it is a legal drug in the US -- which I don't think necessarily includes that it's patented here, just that it's approved by the FDA.

> There's already a huge market for illegal compounds and GPL-1 drugs are available alongside the usual testosterone and other steroids.

The peptide and oils markets are both big, but largely separate -- the peptides folks don't seem to want to be associated with oils. Within peptides, GLP1s definitely dominate, though the other options are pretty popular. In my experience it seems like GLP1s are kind of a "gateway peptide" -- a lot of folks start with a GLP1 on the gray market, and then start to branch out and try the other options available.

dawnerd

6 hours ago

Flights to Canada can be pretty cheap too. Less than the cost of one month so if you flew out every 90 days you’d still come out ahead. Practically not enough people will do this of course. Would be great for people in the border towns though.

eek2121

6 hours ago

I don't know about that, Canada is a beautiful country. If I were on the meds, I wouldn't hesitate to fly out for a day trip every 90 days.

Also, let's be real, anyone in the northeast could be there in a few hours driving. New York City is about 7 hours away from Ottawa, for example.

doubled112

4 hours ago

Detroit and Windsor are a single bridge crossing away from each other. Sarnia and Port Huron too.

I’ve ended up at the border crossing from Niagara Falls to Buffalo by accident before. I was glad when they let me make a U-turn.

digianarchist

4 hours ago

There's a tunnel between Detroit and Windsor. Faster than the bridge sometimes because no trucks.

Marsymars

3 hours ago

> So, though there may be a small amount that would slip through the cracks

Probably depends on enforcement, price delta, and various other variables.

e.g. something like a quarter of smartphones sold in Brazil are smuggled in, more than a small amount slipping through the cracks.

Spooky23

6 hours ago

We don't have laws anymore. Just pay off POTUS so he can declare cheap "fat shots" and let Kushner or Barron own the importer, and you're good.

SecretDreams

4 hours ago

Canada's one of the bigger markets for this product. That aside, think of the percentage of Americans that live driving distance of a Canadian border - it's easy to envision from meaningful lost sales just from normal Americans who go to Canada to shop on the weekend.

glp1guide

6 hours ago

Not only that, there is a legitimate raft of companies lining up to make generics.

There’s one wrinkle though, legally importing prescription drugs from Canada isn’t really allowed in the US/UK AFAIK. HIMS is probably feverishly figuring out how to do that right now.

Shameless plug:

https://glp1guide.substack.com/p/another-glp1-generic-launch...

Also somewhat separately, injectable GLP1s are about to be upstaged by oral variants — orfoglipron for Eli Lilly and the Wegovy Pill for Novo.

ChrisMarshallNY

6 hours ago

> Also somewhat separately, injectable GLP1s are about to be upstaged by oral variants — orfoglipron for Eli Lilly and the Wegovy Pill for Novo.

I believe that this gets a new patent, and will probably be a huge seller.

glp1guide

3 hours ago

Absolutely -- certainly in their biggest markets they'll be able to protect those patents.

Both companies have thus far been unable to really stop compounding pharmacies and/or gray market suppliers from replicating though, and price negotiation with the government is definitely going to happen (Trump recently announced wanting $150 GLP1s, Novo's lawsuit against medicare price negotiation failed)... I do not have much faith in their ability to protect their pricing power for very long, which unfortunate for them is probably what's best for humanity and is very well known at this point.

0cf8612b2e1e

7 hours ago

I had never considered it-what makes a drug prescription vs OTC? Every substance has safety concerns(dose makes the poison), so with a lot of the financial gone, will the GLPs ever not require a prescription?

dlcarrier

6 hours ago

In the US, prescription and OTC are theoretically completely unrelated, but in practice patent holders want their drugs to be prescription, where end users aren't involved in the process of selecting or paying for the drug, whereas generic manufacturers want the drugs to be OTC, where end users are choosing the product in a competitive market.

See, for example, Prilosec (Omeprazole) switching from prescription to OTC.

apike

6 hours ago

The FDA (or equivalent in the relevant country) regulates whether an approved drug requires a prescription based on the safety profile. To be approved for OTC, there is a much higher bar in terms of ease of misuse, side effects, and so on.

choffman

7 hours ago

There's about to be a lot of skinny people in Canada bordering states. :)

TMWNN

7 hours ago

Quoting myself <https://np.reddit.com/r/MapPorn/comments/1md4wde/the_most_va...>:

>Novo Nordisk did not file for a renewal because of a mistake, or someone going on vacation, or anything like that.

>Novo Nordisk decided that the additional years of patent protection were not worth it compared to the advantage of the drug no longer being under the jurisdiction of the PMPRB <https://en.wikipedia.org/wiki/Patented_Medicine_Prices_Revie...>. Whether that decision was financially correct in light of GLP-1's subsequent application to weight loss, I do not know. However, again, it was not a silly mistake on Novo Nordisk's part.

mmooss

2 hours ago

An interesting citation! But you are not an authority on the issue (?) and so not much of a cite. What is yourself's claim based on?

tavavex

6 hours ago

The whole story seems utterly insane to me. The fact that Novo Nordisk went back to ask for a refund of $250 they paid for the patent in 2017 shows that there was active intent behind this, this wasn't just some internal disconnect between payment systems that prevented the money from being sent to the government. Who at NN thought that saving, what, ~$1000 total was justified for this? I thought companies of this scale didn't even think on the scale of thousands of dollars anymore.

Oh well, at least we in Canada get more generic drug variants. Thanks!

tempestn

5 hours ago

Insane to the point that it doesn't seem believable. Even if the patent was worthless it wouldn't have been worth their time to pursue that refund just for the $250.

Another comment here mentioned that patents in Canada come with strings on pricing. So it's possible there was an actual trade-off that was considered here.

HDThoreaun

3 hours ago

Apparently they can get around the government price controls by getting off the patent. I guess they figured it was better to keep prices high so americans didnt border hop but lose the exclusivity sooner

paulpauper

7 hours ago

So would it be possible to buy the drug in Canada and ship to US?

Hilift

7 hours ago

Possible, but considering that US Ozempic revenue is $10 billion per year between only Medicaid and Medicare, that would attract customs attention. The US market was projected to increase to $58 billion by 2035.

rootusrootus

7 hours ago

I think you may need to drive it across, not ship it, and the quantity limit is a 90 day supply. For people who live close enough to the border, it might be worth it.

jasongill

7 hours ago

not legally, but anything is possible

OutOfHere

7 hours ago

There is nothing illegal about it. People get medicines from abroad all the time that are not generic domestically. It's not a controlled substance. One might have to go through unofficial channels though. In fact, I know people domestically who already get it cheaply from elsewhere abroad.

js2

6 hours ago

> In most circumstances, it is illegal for individuals to import drugs or devices into the U.S. for personal use because these products purchased from other countries often have not been approved by the FDA for use and sale in the U.S.

https://www.fda.gov/industry/import-basics/personal-importat...

OutOfHere

3 hours ago

There are a million laws on the books that not only are not enforced, but aren't even self consistent with each other. It is enforcement that determines what one actually can or can't do. The enforcement exists for controlled substances, for resale, and for a supply of over 90 days. For personal non-commercial use of a non-controlled medicine for under 90 days, the law is not enforced, and for good reason. People would die if the law were to be enforced too strictly.

tredre3

30 minutes ago

> There are a million laws on the books that not only are not enforced, but aren't even self consistent with each other. It is enforcement that determines what one actually can or can't do.

Okay but your statement was that there's "nothing illegal about it". You now agree that it's illegal, you're just unlikely to get caught. And if you are, you'll just lose that purchase and not face any legal consequences.