The first generic weight-loss drug hit SA in August — with many expected to follow. Will it be enough to kill the black market?

Since August, South Africa has welcomed its first generic semaglutide injection, a drug renowned for its potential to curb weight gain. However, the discount from its rival, Ozempic, remains modest at around 18.5%. Despite researchers predicting semaglutide could eventually be manufactured for as little as R100–R200 per month, high prices have inadvertently spurred a black market for unregistered weight-loss medications.

This clandestine trade raises concerns about product authenticity, as buyers are left uncertain about the contents of these injections.

The challenge of making affordable generics widely accessible is significant, as 84% of South Africans rely on public healthcare. Consequently, cheaper alternatives may not make a substantial difference for many unless the government steps in to subsidize them. In this newsletter, our team delves into whether lower-cost Ozempic will effectively dismantle South Africa's black market.

The story of semaglutide began in the 1990s when American scientist John Eng discovered a molecule in the venom of the Gila monster, a desert-dwelling lizard in North America. This molecule, akin to the naturally occurring human hormone GLP-1, slows digestion, promotes fullness, and stabilizes blood sugar levels. Eng's discovery laid the groundwork for the blockbuster drug Ozempic, initially prescribed for diabetes but later repurposed as a weight-loss solution amid high demand.

Despite the potential for cost reductions through generics, the prices of GLP-1 medications remain prohibitively high, often ranging from R3,000 to R10,000 per month. This exorbitant cost poses a significant barrier for even high-earning individuals, who find it difficult to afford the treatment. The situation is set to improve, however, as the patents for semaglutide, the active ingredient in Ozempic and Wegovy, have recently expired in several countries, paving the way for the generics market to burgeon.

South Africa's first generic semaglutide injection, launched by Sun Pharma, is now available to those in need. Yet, the question remains: will the availability of cheaper alternatives be sufficient to dismantle the illicit market and ensure that essential medication reaches those who require it most urgently?