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?

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.

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.

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

Remember that back in the dim antiquity of 2017, semaglutide was an experimental drug for type 2 diabetes. The sales explosion only happened a few years later when it started being prescribed for weight loss.

Don't be so quick to assume it was a failure not intentional. One of the comments in the article suggests it could have been to avoid PMPRB which is price control for patented drugs.

That letter from lawyers probably cost more than 250 …

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.

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.

>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.

Thanks, can you point to where you found this info?

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

> AIUI

?

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?

Insulin is cheap everywhere in the world except the US, and it's been around since the 1920s.

The price has nothing to do with Novo Nordisk's distribution of it last century.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8597930/

> in exchange for a promise to use the revenues "for good purposes".

They still do an enormous amount of charity, though activities of the foundation are probably highly localised to Denmark: https://en.wikipedia.org/wiki/Novo_Nordisk_Foundation

There are many different kinds of insulin now, and almost nobody uses the original version, because it's tricky to get timing and dosage right.

All with their own patent situation, of course.

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...

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.

"same as the minimum wage"

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

> 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.

Nonsense.

You can use US prescription at online Canadian pharmacy and legally ship to US. This is how a lot of people save on drugs.

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

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

In Brazil, medicines lose patent protection 20 years after the original filing date. The filing date was in 2006, so the patent expires in 2026.

But note that the patent was only granted in 2019, it took 13 years. They went to court last year, but the justice (as far as I know) has continued to follow the precedent that the original filing date applies.

So they went to the federal government to try to change the law, but the government has refused so far.

The INPI (Brazilian Patent Office) used to take a VERY long time to register/grant patents. It's faster now (about 4 years on average), but it's still slow.

But I'm seeing here that in the US it was 2017. So not that different from 2019 anyway.

PS: Brazil also have several local labs focused on generics, and besides this, there's also state-owned lab, Fiocruz, who makes vaccines and medicines as well, several of them, to distribute though SUS.

In Brazil by the constitution, everyone has the right of health, so if the public health care (SUS) don't distribute, you can sue the governament and get the medicine. So there's a big incentive for the governament to make patents expire as soon as possible to have generics and include on SUS.

e.g Fiocruz manufacture PrEP, and started now PrEP injection (Cabotegravir).

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.

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.

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

$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.

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.

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.

> 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.

Technically true, but in practice you can often get it across the border in personal-dose-level quantities without getting caught.

> 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.

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.

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.

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.

They don’t require one in the UAE (in practice, anyway), which has a well-regulated med scene.

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.

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

The protection (racket) is about selling, not manufacture. Otherwise everyone would just manufacture in china and sell anywhere they like.

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.

Smuggling aside, they generally won't make it through customs: https://www.help.cbp.gov/s/article/Article-1815?language=en_...

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.

not legally, but anything is possible

Also, meditate, fast intermittently, get therapy, and develop healthy ways of handling stress and dissatisfaction.

Everyone’s path is a little different. What is only a little difficult for some might be downright impossible for others (or feel that way).