BHEKISISA: The first generic weight loss drug has hit SA — will it be enough to kill the black market?

{JSON.stringify(article.attachments[0], null, 2)} --> South Africa’s first generic semaglutide injection arrived in August, with many more expected. More competition should push down the price of blockbuster GLP-1 drugs – but will they become cheap enough to stamp out a booming black market and reach the public-sector patients who need them?

It was a carnivorous lizard with a forked tongue, sharp claws and beady skin that helped rewire the appetite of millions of people around the world, making hunger something you can switch off with a few clicks and a jab.

In the 1990s, an American scientist by the name of John Eng identified a molecule in the venom of the Gila monster , which spends most of its life underground in North American deserts. The reptile has an interesting approach to food. It emerges from the darkness just a handful of times each year to feast, and is able to maintain its blood sugar for these long stretches between meals. The molecule Eng found in the reptile acts a bit like the naturally occurring human hormone, glucagon-like peptide-1 , or GLP-1. It slows digestion, makes us feel full and steadies our blood sugar, keeping our energy steady. Eng thought it might somehow help people with diabetes.

What Eng unlocked paved the way for the blockbuster drug Ozempic, which launched in 2017 in the US as treatment for diabetes, but was soon used off-label as a weight loss drug, by an insatiable public.

Financial services firms like Morgan Stanley expect the GLP-1 market to reach $190-billion (about R3.1-trillion) by 2035, more than double what it was worth in 2025.

GLP-1s have become shorthand for brand names including Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity and a slew of others, with more coming as fast as pharmaceutical companies can get them into pens that deliver them in once-a-week jabs and, more recently, in tablet form. But they don’t come cheap.

At between about R3,000 and R10,000 a month , Bhekisisa’s TV programme, Health Beat, reported in July, depending on the type and amount of medication a patient needs, even those pulling down R1-million annual salaries struggle to pay for it.

In March, patents on semaglutide , the ingredient that makes Ozempic and Wegovy work, expired in several countries, opening up the generics market to millions. Earlier this month, Sun Pharma launched the first generic semaglutide injection for type 2 diabetes in South Africa via its local subsidiary, Ranbaxy.