> 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."
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?
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.
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?
It depends what the “simultaneous filing of the CSP” was simultaneous with. If it was simultaneous with letting the patent expire that makes no sense. If it was simultaneous with the original filing of the patent that does make sense.
Based on the gov website it sounds like it has to be filed within 120 days of filing the patent, so i guess its the latter.
It might not be as nonsensical as the alternative, but I still dont understand how the CSP filing makes it any less likely letting the patent lapse was a mistake.
I think it's interpreted as meaning that the company is generally committed to patent protection, and so if they let it lapse in this case despite several warning letters that it's more likely it was a conscious decision for commercial reasons. Which is what they claim. I don't think it's a particularly strong argument.
Ah yes, the ole', it can't be a mistake because companies don't make mistakes therefor it must have been intentional.
I know you're not the one making the argument but it really is rediculously silly to argue that it must be an intentional action to not do something because in the past the company wanted to do the thing. While duh, a mistake by definition is something you dont want to do.
Back in 2018, it wasn't widely known that Ozempic would become a blockbuster weight loss drug. So it was possible they made the business decision based on its more limited use as a diabetes drug.
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".
Yeah, Lowe doesn't work for Science -- he is a pharmaceutical chemist who has worked for various companies -- his "In the Pipeline" blog is interesting because while academic scientists often blog, industrial ones rarely do (perhaps for legal/IP reasons).
You just described how the general public should view opinion pieces but acts like the previous comment and assumes it is "news". (To add: this is very human to do)
Then they'd be better off removing this section if "editorially independent" means "we will take things that even in their headline may not be true at all".
It's a blog. It references an interview. The post is also four month old.
"In the Pipeline" is generally a fantastic resource on the pharma industry and chemistry news.
Not really. It doesn't look like a blog, and it's not a person/org's specific blog post. It's just called "blog" in a breadcrumb somewhere, which most people won't read. It's actual a guest editorial, but still - doesn't really look like one.
Yeah, it really is, even if what's linked to is one post rather than the entire blog.
His stuff pops up here often enough. He really does blog at Science. Has for years and years.
If you have a background in chemistry, it's fairly accessible (i.e., he very rarely talks about anything in a depth that an undergrad chem major would have trouble understanding - which, given that most chemists start branching off very quickly in grad school, is roughly the appropriate depth for writing intended for a general chemistry audience, since it's the last common knowledge level).
> Derek Lowe’s commentary on drug discovery and the pharma industry. An editorially independent blog, all content is Derek’s own, and he does not in any way speak for his employer.
The top of the sidebar describes what "In the Pipeline" is.
> 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.
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.
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.
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.
That may be true if IP is not your core business but it is basically the core business of pharmaceutical companies. I don't speak from experience but it would seem surprising to me that any major pharma would outsource IP protection in a major market to contractors they can't sue for billions if they mess up.
It seems much more likely to me that they did it on purpose, as they claim to have.
> 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.
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.
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.
I've read a little about Novo Nordisk's history and it is a pretty interesting story about aligning financial success with human flourishing. The pharmaco is a subsidiary of a anti-diabetes foundation started from proceeds from getting permission to produce insulin.
The foundation has an objective of providing support for scientific, humanitarian and social purposes. . . . In 2024, the foundation distributed a total of DKK 10.1 billion (approx. $1.39 billion) and paid out DKK 6.9 billion ($1.08 billion) in grants. [0]
A drug is almost never acquired that can then be put directly to patients and sold.
Large pharma makes strategic bets on several drugs, some initiated in house, others acquired, but they all just go through further optimization and testing before it is approved.
Huge RnD is required even if drug is “simply acquired”
Having seen AstraZeneca inside, this is not the case. There's quite a lot of development going on. It is all non-fundamental though, the focus is heavily on late stage. No identification of disease mechanisms and such.
> 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.
It could be something as simple as answering the phone. Or checking if the default image for a product on an ecommerce website exists. If you answer the phone or write a quick script to check if the default image exists, now you sort of become the person who is "expected" to do this task.
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.
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.
Uh, Novo is having an absolutely massive firing round; the CEO got axed first and Denmark now has a glut of qualified unemployed which we're all doing our best to hire ASAP :D (we just had the lowest unemployment rate in our history)
(Novo hired _way_ too many people because 'infinite money')
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.
> 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.)
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.
> got themselves a military base being built on American land now too
As a European I'm as critical of the US government as can be and their president has definitely been bought, but there are already several countries that have some training facilities and military personnel in the US.
Calling it a foreign military base is really unnecessarily hyperbolic. And given the amount of military bases that the US have on foreign land, the outrage also seems a bit misplaced.
For those downvoting: we sell fighter jets to many countries, including the UAE. They send pilots here to train on flying these jets. Those pilots need a place to stay.
For their own security protocols, among other reasons, many partner nations prefer to have a small area set up, think of it like a consulate, where their people stay within their own jurisdiction, rather than a hotel. The UAE is setting up such a place for its pilots.
That is all.
This isn’t a force-projection military base on US soil.
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? :)
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.
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.
Of course you can buy medicine abroad and legally bring 90 day doses.
More over, you can order and ship medicine, including ozempic and zepbound, using American prescription from Canadian online pharmacies. For some drugs it’s quite cheaper than paying American prices.
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.
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).
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.
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.
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.
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.
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.
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.
There are places to get it WAY cheaper than that. I started off buying single vials for big money until I found group buys. Once my wife started using them too it was going to be too damn expensive to buy single vials. You can get kits (packs of 10 vials) for a lot less money. Been doing this 2 years now!
This sounds like something the current SCOTUS should be more than happy to shoot down, no? If you're bringing medication for yourself from abroad that you obtained legally, why should the FDA's concerns for your own safety trump (no pun intended) your freedom?
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.
The company said it was intentional, probably because of the reason you mentioned: “In a statement to Fortune, Novo Nordisk said there was no mistake regarding its patent maintenance fee in Canada.”
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.
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.
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.
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.
yes, the US govt is being shockingly lax in its IP enforcement here. i suspect it would be much harder to acquire if ozempic/wegovy were produced by an American company
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?
Compounding isn't some shady enterprise. Its a standard medical use case. I have to use metronidozol cream on my face, but I'm allergic to some preservatives, so a compounding pharmacy makes a version of metronidozol cream without my allergens.
It's also relatively common for toddlers who need special doses, or for people who can't swallow pills and need liquid formulations.
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.
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.
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.
> 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.
>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.
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.
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...
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...
Depends the price of the generics, of course. But I wouldn't doubt if the governament itself would manufacture it. Fiocruz (federal gov lab) already manufacture several drugs.
Also, Rio mayor already said he will just give to everyone basically lol
You also need to remind that on a public health care system, having less obese people means you'll spend less on health care.
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.
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.
totally agree. was pointing out things left out from the previous comment which was kinda of impling gov would be paying all uses of the sliming drugs, even if on generics price. ... because those drugs make profit not because of it's health benefits.
First, it seems obvious to me that they'll prescribe it to everyone who, supposedly, undergoes bariatric surgery through the SUS. Generic Ozempic is certainly cheaper than bariatric surgery.
That said, I believe it will go even further.
To get medication through the SUS, you only need a prescription from a doctor. Any doctor. So even if the SUS itself don't prescribe, you can just find a doctor who will do it...
But, likely SUS will prescribe anyway. Rio mayor:
"Rio will be a city where there will be no more chubby people; everyone will be taking Ozempic at family clinics." "Said the mayor, adding that he has already taken the medication. He claimed to have lost 30kg with the medication."
> To get medication through the SUS, you only need a prescription from a doctor.
Not in all cases. They can and will make the patient and multiple doctors fill out half a dozen forms to "justify" the use of an expensive medication.
Probably won't happen at first, politicians need to make good on their promises after all. But it will happen. I just got done filling out the forms for a COPD medication that's much cheaper than semaglutide. Only political intervention can save it.
> Not in all cases. They can and will make the patient and multiple doctors fill out half a dozen forms to "justify" the use of an expensive medication.
But any doctor can do it, not just SUS doctors. You know the country we live in. Private doctors will do the prescription... Actually, to buy it you already need a prescription, and yet, even skinny healthy folks buy ozempic.
And to get in the SUS, it's pretty simple here in Paraná at least (and as a SUS user). The worst that happens, it's that for expensive/controlled medicines, they centralize into a single public pharmacy in the city center, and you need to schedule a day/time, and bring the ID - don't even need to be the user, you can ask anyone you want to get it if the prescription and ID it's there.
Which is why for my cheap medicine, I prefer to buy it. Not worth for me going to city center only for 30 pills that cost R$ 15.
It is prescribed to the morbidly obese. It's just that patients almost always opt for cheaper options when I inform them of the costs of the treatment. Even if our public health care system starts offering semaglutide, it is extremely likely that it will impose requirements and require "justification" for the use of the medicine. You know, the usual soulless kafkaesque bureaucracy. It can frustrate people so much they give up. I've seen it.
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.
It’s not so straightforward, though. In the U.S., wages are usually discussed in terms of hourly pay or annual salary, whereas in Brazil, they’re typically expressed as monthly earnings.
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.
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.
This was made abundantly clear to me in 2020. It's a mass hysteria fueled by trypanophobia in a vast population of people who aren't very interested in self-analysis and understanding how their own behavior and thought patterns are driven by the amygdala.
One bit of evidence for this: SARMS are huge in the bodybuilding as "gateway steroids". They don't work, they have bad side effects, but hey, they're oral.
A bit late, but thanks for noting this -- I had no idea that this workaround was so well established. I don't often dive into concrete suggestions on how to obtain GLP1s because of how it could be perceived, but maybe I've underestimated how many people know how to do this right now.
> 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?
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.
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).
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. :)
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.
> 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.
> 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:
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.
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.
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.
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.
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.
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.
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?
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.
What's shocking here is that it costs several hundred dollars per year to have a big country enforcing a monopoly for you. I mean at least taking % of the revenue would make sense (and preferably for others to buy out underutilized patents).
As it is it's just corporate welfare - enforcing lucrative market monopoly for an equivalent of a steak dinner for two.
It sounds like people will be flocking to Canada to fill their ozempic prescriptions. However, the WP just posted this article about how ordering rx meds from Canada has become unaffordable due to tariffs.
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!
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
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.
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.
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.
> 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.
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.
> 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.
It's not about getting caught. It's done in the open with full awareness of everyone. It's not like anyone is hiding it.
Afaik, people hide it only for some controlled substances.
Next time you play a random music video on YouTube, please look at the number of federal copyright laws you're violating. Also, if you ever drive from one state to another, check if you have any plant food with you because crossing state lines with any plant material may be illegal. And I need not remind of marijuana which we know remains highly illegal at the federal level.
You seem to be missing the point. You said, "there is nothing illegal about it".
That's false: it is entirely illegal.
Whether or not you can get away with it due to lax enforcement, or whether or not there are any real penalties for getting caught... that's a separate issue that has nothing to do with what you said.
When the diversity of laws are not even logically self-consistent, with one law denying a right and the other permitting it, what defines what is legal and what isn't? Enforcement does.
Additionally, some laws are not even written clearly, and in fact are intentionally written vaguely.
No, those things aren't nearly as important. Handling stress and therapy can also be replaced by some physical activity as well.
General advice that would work for 95% of people shouldn't be criticised because it doesn't address the other 5%. If people did it then there'd be far more money in the system to pay for usefully targetted specialist treatment for those people.
If we are talking about overweight people, then I think your 95% figure is backwards. Maybe 5% can stick to that regimen without addressing what’s going on between their ears. Likely, your perspective is skewed by the crowd you hang out with or from seeing other people at the gym. That’s not a representative cross-section of the population, particularly with respect to people who are overweight.
The emotional/psychological side is important, because the person must make long term changes in their lifestyle.
People tend to over-eat for a reason, and typically it is a reaction to stress or some emotional/psychological need which isn’t being met.
Intermittent fasting can help with appetite suppression and blood sugar spikes. Our bodies didn’t evolve to snack all day long. More likely, we gorged and fasted depending on what was available.
There’s a book called “The Carbohydrate Addict’s Diet” which promotes intermittent fasting to lose weight, and I think it’s on the right track, although the book recommends taking in calories only during a one hour period each day, which for me was too extreme.
I do think it’s beneficial to fast for at least 6 hours once a day, if possible. It’s good for your blood sugar as well as your gut. It can give you more energy and help you feel more like exercising.
Since we are pulling numbers out of our asses can you tell me what good advice that 95% of the people aren't capable of following is? It's great that our national health institutes advices us, but can you explain how the advice isn't completely useless in this particular context? To me it comes off as arrogant and rude.
I didn't say 95% of people aren't capable of following some advice. That would be bad advice. I'm saying this is good advice, because 95% of people can follow it.
> 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."
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?
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.
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.
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.
It depends what the “simultaneous filing of the CSP” was simultaneous with. If it was simultaneous with letting the patent expire that makes no sense. If it was simultaneous with the original filing of the patent that does make sense.
Based on the gov website it sounds like it has to be filed within 120 days of filing the patent, so i guess its the latter.
It might not be as nonsensical as the alternative, but I still dont understand how the CSP filing makes it any less likely letting the patent lapse was a mistake.
I think it's interpreted as meaning that the company is generally committed to patent protection, and so if they let it lapse in this case despite several warning letters that it's more likely it was a conscious decision for commercial reasons. Which is what they claim. I don't think it's a particularly strong argument.
Ah yes, the ole', it can't be a mistake because companies don't make mistakes therefor it must have been intentional.
I know you're not the one making the argument but it really is rediculously silly to argue that it must be an intentional action to not do something because in the past the company wanted to do the thing. While duh, a mistake by definition is something you dont want to do.
Back in 2018, it wasn't widely known that Ozempic would become a blockbuster weight loss drug. So it was possible they made the business decision based on its more limited use as a diabetes drug.
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".
Yeah, Lowe doesn't work for Science -- he is a pharmaceutical chemist who has worked for various companies -- his "In the Pipeline" blog is interesting because while academic scientists often blog, industrial ones rarely do (perhaps for legal/IP reasons).
You just described how the general public should view opinion pieces but acts like the previous comment and assumes it is "news". (To add: this is very human to do)
Then they'd be better off removing this section if "editorially independent" means "we will take things that even in their headline may not be true at all".
It's a blog. It references an interview. The post is also four month old. "In the Pipeline" is generally a fantastic resource on the pharma industry and chemistry news.
> It's a blog.
Not really. It doesn't look like a blog, and it's not a person/org's specific blog post. It's just called "blog" in a breadcrumb somewhere, which most people won't read. It's actual a guest editorial, but still - doesn't really look like one.
> it's not a person/org's specific blog post
Yeah, it really is, even if what's linked to is one post rather than the entire blog.
His stuff pops up here often enough. He really does blog at Science. Has for years and years.
If you have a background in chemistry, it's fairly accessible (i.e., he very rarely talks about anything in a depth that an undergrad chem major would have trouble understanding - which, given that most chemists start branching off very quickly in grad school, is roughly the appropriate depth for writing intended for a general chemistry audience, since it's the last common knowledge level).
> Derek Lowe’s commentary on drug discovery and the pharma industry. An editorially independent blog, all content is Derek’s own, and he does not in any way speak for his employer.
The top of the sidebar describes what "In the Pipeline" is.
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?
> 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...
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.
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.
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.
That may be true if IP is not your core business but it is basically the core business of pharmaceutical companies. I don't speak from experience but it would seem surprising to me that any major pharma would outsource IP protection in a major market to contractors they can't sue for billions if they mess up.
It seems much more likely to me that they did it on purpose, as they claim to have.
> 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.
This isn't what that joke means.
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.
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.
But are you the pharma companies? It's not mandatory to identify that strongly with your employer.
I may be wrong, but aren't most drugs sold by large pharma companies actually developed elsewhere and then acquired?
Novo Nordisk does the vast majority of their RD in-house. I can’t speak to other companies.
I've read a little about Novo Nordisk's history and it is a pretty interesting story about aligning financial success with human flourishing. The pharmaco is a subsidiary of a anti-diabetes foundation started from proceeds from getting permission to produce insulin.
The foundation has an objective of providing support for scientific, humanitarian and social purposes. . . . In 2024, the foundation distributed a total of DKK 10.1 billion (approx. $1.39 billion) and paid out DKK 6.9 billion ($1.08 billion) in grants. [0]
0. https://en.wikipedia.org/wiki/Novo_Nordisk_Foundation
A drug is almost never acquired that can then be put directly to patients and sold.
Large pharma makes strategic bets on several drugs, some initiated in house, others acquired, but they all just go through further optimization and testing before it is approved.
Huge RnD is required even if drug is “simply acquired”
Having seen AstraZeneca inside, this is not the case. There's quite a lot of development going on. It is all non-fundamental though, the focus is heavily on late stage. No identification of disease mechanisms and such.
> 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.
It could be something as simple as answering the phone. Or checking if the default image for a product on an ecommerce website exists. If you answer the phone or write a quick script to check if the default image exists, now you sort of become the person who is "expected" to do this task.
Boggles my mind.
Spot on. Often it's also thankless tasks whilst being foundation for the company to run. Someone has to answer the phone.
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.
> 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.
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.
They are getting fired now - as Novo is in major crisis mode and going through its largest layoffs ever.
to me, I am reminded of countless DNS renewal mistakes that are publicized.
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.
Is this the patent equivalent of letting your website's cert expire?
More like letting the domain expire, and someone else snapping it up before you can renew.
Uh, Novo is having an absolutely massive firing round; the CEO got axed first and Denmark now has a glut of qualified unemployed which we're all doing our best to hire ASAP :D (we just had the lowest unemployment rate in our history)
(Novo hired _way_ too many people because 'infinite money')
I mean the CEO got fired…
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.
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.
With de minimis for US-bound packages suspended I suspect way more packages are inspected than used to be.
> 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.)
You can import from UAE without paying any duties or fees?
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.
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.
> got themselves a military base being built on American land now too
As a European I'm as critical of the US government as can be and their president has definitely been bought, but there are already several countries that have some training facilities and military personnel in the US.
Calling it a foreign military base is really unnecessarily hyperbolic. And given the amount of military bases that the US have on foreign land, the outrage also seems a bit misplaced.
I suspect he was repeating a soundbite and doesn’t know the actual (entirely reasonable) situation.
For those downvoting: we sell fighter jets to many countries, including the UAE. They send pilots here to train on flying these jets. Those pilots need a place to stay.
For their own security protocols, among other reasons, many partner nations prefer to have a small area set up, think of it like a consulate, where their people stay within their own jurisdiction, rather than a hotel. The UAE is setting up such a place for its pilots.
That is all.
This isn’t a force-projection military base on US soil.
Higher enforcement demands probably lead to more stuff slipping through.
You should be able to travel with a 90 day supply without issue.
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? :)
https://news.ycombinator.com/item?id=45638316
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.
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.
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?
Of course you can buy medicine abroad and legally bring 90 day doses.
More over, you can order and ship medicine, including ozempic and zepbound, using American prescription from Canadian online pharmacies. For some drugs it’s quite cheaper than paying American prices.
Sounds like an opportunity for non-residents.
The major legal question for generic Ozempic imports will be, did Novo Nordisk buy Trump coins or donate to the White House ballroom?
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.
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.
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)
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).
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.
While I agree and this all seems reasonable, I think you give the average person far too much credit.
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.
How do they have confidence that the vials they're getting are sterile / pure / free of endotoxins / etc?
[dead]
This is commonly done for injectable fertility treatments, though in my experience they are hydrated just before use.
If you live near the border, of if you regularly travel to Canada anyways, then the travel cost isn't an issue.
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.
That would be MDMA.
Wait, but where does Elon's ketamine come from?
Doesn't he have his own legal lab?
Mars
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.
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.
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.
There are places to get it WAY cheaper than that. I started off buying single vials for big money until I found group buys. Once my wife started using them too it was going to be too damn expensive to buy single vials. You can get kits (packs of 10 vials) for a lot less money. Been doing this 2 years now!
I guess so, but I was just curious and I made a quick search.
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.)
Just don’t do it in a speed boat.
More government attacks on the freedom of law-abiding speed boat owners
https://www.fda.gov/industry/import-basics/personal-importat...
This sounds like something the current SCOTUS should be more than happy to shoot down, no? If you're bringing medication for yourself from abroad that you obtained legally, why should the FDA's concerns for your own safety trump (no pun intended) your freedom?
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.
The company said it was intentional, probably because of the reason you mentioned: “In a statement to Fortune, Novo Nordisk said there was no mistake regarding its patent maintenance fee in Canada.”
I still don’t get that though: is that worth losing exclusivity over?
I guess they think some other production patent will let them maintain exclusivity without it being a patent on the drug itself?
That letter from lawyers probably cost more than 250 …
The sad thing is they probably were billed 500 dollars for the lawyers to “read” it.
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.
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.
Maybe they'd even do it in exchange for just low-cost general availability in Canada!
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.
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.
The US price for name brand is around $500/mo. More than $175, but not $800.
Only now at Costco. It used to be much higher
No. Directly from Novo, prior to the Costco announcement.
The only thing that changes with Costco is you can get the auto-injector version for that price, instead of vials.
I always thought they had auto-injectors
500 usd = 700 cad. So probably more an imprecise currency issue.
Everyone I know taking these is buying generic compounded formulas. Insurance mostly doesn’t cover it so the go for the cheaper options.
yes, the US govt is being shockingly lax in its IP enforcement here. i suspect it would be much harder to acquire if ozempic/wegovy were produced by an American company
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?
> 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.
I should be more specific. Compounding Ozempic isn't allowed since it is not considered to be a shortage anymore by Health Canada.
Compounding isn't some shady enterprise. Its a standard medical use case. I have to use metronidozol cream on my face, but I'm allergic to some preservatives, so a compounding pharmacy makes a version of metronidozol cream without my allergens.
It's also relatively common for toddlers who need special doses, or for people who can't swallow pills and need liquid formulations.
Compounding is normal.
My comment was in reference to compounding for straight Ozempic prescriptions, which is currently not allowed in Canada since it is not in shortage.
I was making no judgement on compounding generally.
Yes I’m in the USA. I just mentioned that because nobody I know is paying $800/mo. They are buying compounded injections online.
roughly how much are they paying, then?
I pay about $300 for a “one month supply”, which lasts me around 12 weeks.
Probably half that, or less.
> Compounding isn't allowed in Canada, currently
How does this work? Why/when would compounding not be allowed?
If health Canada determines there is a shortage, compounding is allowed. Health Canada has determined that there is no longer a shortage.
Does the government/medical insurance subsidise that price though?
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.
>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.
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.
> 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?
Thanks, can you point to where you found this info?
Sorry, pieced together from different sources.
I am not an expert.
Here's one about the price control on patented drugs: https://www.torys.com/our-latest-thinking/publications/2024/...
See the comments on that article where a few people have pointed this out.
Seems like a plausible explanation, the government should reform the price regulation laws to avoid this endrun around price controls.
> AIUI
?
As I understand it?
TYNIU
As I Understand It
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.
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?
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.
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.
I should how so, considering the discovery I'm talking about happened in 1921.
Insulin is so easy to make clickbait and ragebait with due to people not knowing, or willfully ignoring, that “insulin” is not one specific medicine.
Kind of crazy considering how many people have diabetes.
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...
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...
Depends the price of the generics, of course. But I wouldn't doubt if the governament itself would manufacture it. Fiocruz (federal gov lab) already manufacture several drugs.
Also, Rio mayor already said he will just give to everyone basically lol
You also need to remind that on a public health care system, having less obese people means you'll spend less on health care.
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.
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.
totally agree. was pointing out things left out from the previous comment which was kinda of impling gov would be paying all uses of the sliming drugs, even if on generics price. ... because those drugs make profit not because of it's health benefits.
First, it seems obvious to me that they'll prescribe it to everyone who, supposedly, undergoes bariatric surgery through the SUS. Generic Ozempic is certainly cheaper than bariatric surgery.
That said, I believe it will go even further.
To get medication through the SUS, you only need a prescription from a doctor. Any doctor. So even if the SUS itself don't prescribe, you can just find a doctor who will do it...
But, likely SUS will prescribe anyway. Rio mayor:
"Rio will be a city where there will be no more chubby people; everyone will be taking Ozempic at family clinics." "Said the mayor, adding that he has already taken the medication. He claimed to have lost 30kg with the medication."
> To get medication through the SUS, you only need a prescription from a doctor.
Not in all cases. They can and will make the patient and multiple doctors fill out half a dozen forms to "justify" the use of an expensive medication.
Probably won't happen at first, politicians need to make good on their promises after all. But it will happen. I just got done filling out the forms for a COPD medication that's much cheaper than semaglutide. Only political intervention can save it.
> Not in all cases. They can and will make the patient and multiple doctors fill out half a dozen forms to "justify" the use of an expensive medication.
But any doctor can do it, not just SUS doctors. You know the country we live in. Private doctors will do the prescription... Actually, to buy it you already need a prescription, and yet, even skinny healthy folks buy ozempic.
And to get in the SUS, it's pretty simple here in Paraná at least (and as a SUS user). The worst that happens, it's that for expensive/controlled medicines, they centralize into a single public pharmacy in the city center, and you need to schedule a day/time, and bring the ID - don't even need to be the user, you can ask anyone you want to get it if the prescription and ID it's there.
Which is why for my cheap medicine, I prefer to buy it. Not worth for me going to city center only for 30 pills that cost R$ 15.
crazy politicians will be crazy politicians.
sadly rio is exporting them.
Why wouldn't it be prescribed to morbidly obese people?
It is prescribed to the morbidly obese. It's just that patients almost always opt for cheaper options when I inform them of the costs of the treatment. Even if our public health care system starts offering semaglutide, it is extremely likely that it will impose requirements and require "justification" for the use of the medicine. You know, the usual soulless kafkaesque bureaucracy. It can frustrate people so much they give up. I've seen it.
"same as the minimum wage"
... an hour's wage? a week? a month? annual?
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.
"entire income" is just as opaque. "monthly income" is what I was looking for. maybe clear to you (how?), but obviously not to everyone.
It’s not so straightforward, though. In the U.S., wages are usually discussed in terms of hourly pay or annual salary, whereas in Brazil, they’re typically expressed as monthly earnings.
Doesn't matter.
$(recurring dose of drug) ~= $(recurring income)
However much you need per unit time period, compared to how much you make in that time period.
The definition is independent of time.
Well, no. The comment mentioned a _single dose_ of Ozempic costing the entire income. Hence my question.
Yeah, sorry, it's just here we just talk about monthly wages. A month!
thanks!
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.
> 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.
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.
I suspect a lot of the anti-vaxx movement is subconsciously motivated by fear of needles.
So yeah, I expect the pill form to be a huge seller!
This was made abundantly clear to me in 2020. It's a mass hysteria fueled by trypanophobia in a vast population of people who aren't very interested in self-analysis and understanding how their own behavior and thought patterns are driven by the amygdala.
One bit of evidence for this: SARMS are huge in the bodybuilding as "gateway steroids". They don't work, they have bad side effects, but hey, they're oral.
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.
A bit late, but thanks for noting this -- I had no idea that this workaround was so well established. I don't often dive into concrete suggestions on how to obtain GLP1s because of how it could be perceived, but maybe I've underestimated how many people know how to do this right now.
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
> 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?
1. In the USA people use compounding companies to get around patents.
2. https://www.reuters.com/business/healthcare-pharmaceuticals/...
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.
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).
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. :)
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.
> 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.
Plenty of countries where having a doctor in the pharmacy is common practice. Buy some retail space in YYZ and you're set...
> you can't fill a foreign prescription without having a local doctor sign off on it
This is how medical tourism typically works.
Is that process that can happen online? Or does it require the patient being physically present in Canada?
Can be done virtually but you might have to use a VPN or even lie about your place of residence.
Depends on province. From my best reading, pharmacists in Alberta with prescribing authority can directly prescribe all schedule 1 drugs themselves.
> 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...
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.
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.
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.
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.
You're probably right. I scanned the FDA website and wasn't sure how easy it would be to meet the requirements for personal medicine importation [0].
As a Canadian national in the US I wouldn't even attempt doing this in the current political climate.
[0] https://www.fda.gov/industry/import-basics/personal-importat...
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.
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.
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.
There's a tunnel between Detroit and Windsor. Faster than the bridge sometimes because no trucks.
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.
> 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.
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.
> 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.
looking at the filing, they had their patent deadline extended due to COVID-19 eighteen times!
https://brevets-patents.ic.gc.ca/opic-cipo/cpd/eng/patent/26...
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?
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.
What's shocking here is that it costs several hundred dollars per year to have a big country enforcing a monopoly for you. I mean at least taking % of the revenue would make sense (and preferably for others to buy out underutilized patents).
As it is it's just corporate welfare - enforcing lucrative market monopoly for an equivalent of a steak dinner for two.
It sounds like people will be flocking to Canada to fill their ozempic prescriptions. However, the WP just posted this article about how ordering rx meds from Canada has become unaffordable due to tariffs.
Many seniors get cheaper medicine from Canada. That might become harder https://www.washingtonpost.com/business/2025/10/18/deminimis...
No paywall: https://archive.ph/nT0Jl
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!
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
There's about to be a lot of skinny people in Canada bordering states. :)
Does it mean that Sandoz can start production of a generic in Canada and sell it e.g. in Europe?
The protection (racket) is about selling, not manufacture. Otherwise everyone would just manufacture in china and sell anywhere they like.
So would it be possible to buy the drug in Canada and ship to US?
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
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.
> 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...
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.
> 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.
It's not about getting caught. It's done in the open with full awareness of everyone. It's not like anyone is hiding it.
Afaik, people hide it only for some controlled substances.
Next time you play a random music video on YouTube, please look at the number of federal copyright laws you're violating. Also, if you ever drive from one state to another, check if you have any plant food with you because crossing state lines with any plant material may be illegal. And I need not remind of marijuana which we know remains highly illegal at the federal level.
You seem to be missing the point. You said, "there is nothing illegal about it".
That's false: it is entirely illegal.
Whether or not you can get away with it due to lax enforcement, or whether or not there are any real penalties for getting caught... that's a separate issue that has nothing to do with what you said.
When the diversity of laws are not even logically self-consistent, with one law denying a right and the other permitting it, what defines what is legal and what isn't? Enforcement does.
Additionally, some laws are not even written clearly, and in fact are intentionally written vaguely.
[dead]
Eat healthy. Do sports. Sleep well. Repeat.
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).
No, those things aren't nearly as important. Handling stress and therapy can also be replaced by some physical activity as well.
General advice that would work for 95% of people shouldn't be criticised because it doesn't address the other 5%. If people did it then there'd be far more money in the system to pay for usefully targetted specialist treatment for those people.
If we are talking about overweight people, then I think your 95% figure is backwards. Maybe 5% can stick to that regimen without addressing what’s going on between their ears. Likely, your perspective is skewed by the crowd you hang out with or from seeing other people at the gym. That’s not a representative cross-section of the population, particularly with respect to people who are overweight.
The emotional/psychological side is important, because the person must make long term changes in their lifestyle.
People tend to over-eat for a reason, and typically it is a reaction to stress or some emotional/psychological need which isn’t being met.
Intermittent fasting can help with appetite suppression and blood sugar spikes. Our bodies didn’t evolve to snack all day long. More likely, we gorged and fasted depending on what was available.
There’s a book called “The Carbohydrate Addict’s Diet” which promotes intermittent fasting to lose weight, and I think it’s on the right track, although the book recommends taking in calories only during a one hour period each day, which for me was too extreme.
I do think it’s beneficial to fast for at least 6 hours once a day, if possible. It’s good for your blood sugar as well as your gut. It can give you more energy and help you feel more like exercising.
Since we are pulling numbers out of our asses can you tell me what good advice that 95% of the people aren't capable of following is? It's great that our national health institutes advices us, but can you explain how the advice isn't completely useless in this particular context? To me it comes off as arrogant and rude.
I didn't say 95% of people aren't capable of following some advice. That would be bad advice. I'm saying this is good advice, because 95% of people can follow it.