>Novo Nordisk’s lawyers requested a refund for the paid 2017 maintenance fee of $250 Canadian dollars ($185) because the company wanted more time to see if it wanted to pay it, according to letters included in the documents.
>Two years later, the office sent a letter saying the fee, which now included a late charge bringing the total to CA$450, was not received by the prescribed due date.
>Novo Nordisk had a one-year grace period to pay, but never did, and so its patent lapsed in Canada. It lapsed in 2020 when the fee was not received, but it doesn’t expire until January.
Can't find the post on Reddit right now, but someone broke all three down and it is more nuanced. They act slightly differently in different areas.
Before I started experiments on "my lab rat" with retatrutide, I found that combination of the about half max dose of semaglutide and 1/3 of Max dose of tirzepatide had the best combination of losing weight and lowering side effects. But another "lab rat" did not respond that well to this combo and we keep adjusting it.
Retatrutide so far looks the most compatible, but it is sample of 1.
Retatrutide looks to be very effective, but it's not possible to get legally/safely at this point. TONS of experience/knowledge in the r/retatrutide subreddit though, a lot of pretty conscientious consumers in there that have done their research, but obviously impossible to recommend outside of finding a sanctioned study to join.
That said, Reta is a triple agonist[0] and it seems to be quite amazing with good muscle retention as well -- it's unclear if this is just the people who are taking it being more likely to be gym goers. Up until now the only formulation I've seen that specifically targets preserving muscle is GLP1s in combination with bimagrumab[1].
This is where I failed as a psychologist because I don't have extensive training in pharmacodynamics, so I forgot that "potent" is a specific term in that world. What I meant was: I subjectively believe that Semaglutide is the best choice for weight loss, given the overall profile and response in my subjective clinical experience.
A fancy way of saying: I *think* Semaglutide is best.
Ah -- the linked research trial contains evidence that it is not the best, Tirzepatide is more effective.
Unless you mean that Semaglutide worked best for you, right now the research points at Tirzepatide being most effective for weight loss (says nothing about t2d though).
I'll note that in the US that 1000+ is the "list price". For those paying out of pocket, both zepbound and wegovy offer coupons available to anyone taking it down to $500 (and I'll note that discounted price keeps coming down, slowly, as well)
Yeah, the drug + the injector together are the patentable thing. When the first patent nears expiration, they work on an iteration of the injector or a time release change for the drug, then they get another few decades of product monopoly.
They have also made a business of either stifling or “catch and kill”ing of the generics for their products. It’s cheaper to pay off a generic manufacturer to not compete with the new thing than it is to lose price elasticity of the n non-generic.
I didn’t make the claim that the expired patent prevented the practice.
My comment was a quick and sloppy summary from my memory of an interview from several years ago. I think it was the EconTalk with the author of Drug Wars.
A more detailed and comprehensive list of these tactics to reduce competition either during or after patent expiry:
Patent-related strategies:
• Building “patent thickets” by filing multiple patents on different aspects of the same drug (formulation, dosing, manufacturing processes)
• “Evergreening” - seeking new patents on minor modifications to extend exclusivity periods
• Filing continuation patents and divisional applications to extend patent timelines
Product lifecycle management:
• “Product hopping” - making minor reformulations or switching to extended-release versions just before generic entry to move patients to the new version
• Discontinuing older versions that generics would reference
Legal and regulatory tactics:
• Pay-for-delay settlements where brand companies pay generics to postpone market entry
• Manipulating FDA safety programs (REMS) to make it difficult for generics to obtain necessary samples for testing
• Citizen petitions to the FDA raising questions about generic equivalence
Market-based approaches:
• Launching “authorized generics” through subsidiaries to capture generic market share
• Exclusive dealing arrangements with pharmacy benefit managers
Like I said above, they don't extend exclusivity or prevent practice of expired IP. All you have to do is not infringe the new IP. this is what the article says too. I disagree with their greater claim; The patents aren't rocket science- most are extremely easy to read, and the authors are hiding behind weasel worlds like "may" and "could"
There are some bad patents that should never have been granted, like Novartis' famous 631 patent [1]. However, those are the exception, not the rule. If you want to put a generic drug into an auto injector, there are a dozen generic autoinjector companies looking to take your money. Drug + autoinjector does not pass the US patent office non-obviousness test (for obvious reasons). What gets patents is custom design features - bells and whistles. New features are part of the roadmap because customers will prefer them over competition without them, not because it magically extends prior IP (that isn't a thing).
What I’ve noticed, is work on extended release formulations only occur close to or near the time of patent expirations.
It’s rarely because of a new technological breakthrough, but rather a way of drug companies lengthening the time they can profit off a drug.
If they released it earlier they would simply take market share from themselves, but by releasing it close to the time of generics they take market share from generics.
Why didn’t Wegovy come out 5 years sooner? Why does it use a different injector than Ozempic? I don’t know but sounds quite similar to the ER/XR strategy.
> Drug manufacturers listed 22 patents after FDA approval of the 10 products in the cohort...Post-approval patents only extended the duration of protection on 2 products (median 4.6 years.
This is makes sense if there is actually something novel to add [keeping in mind the authors are treating any IP as if it protects the entirety of the product. A sugar coating or whatever wont protect the non-sugar coated pill.
To the extent I agree with the paper, it is that the 30 month hold is weaponized and should be reviewed and the issue with settlements should be addressed
There are dozens of autoinjector manufacturers, and generics can and do change manufacturers. It looks like semaglutide uses an off the shelf Yposomate pen, although Novo Nordisk uses different injectors depending on the country and indication.
Novo Nordisk also has an in house pen, but this would not prevent someone from competing, unless patients simply prefer that design to a generic one.
I'm no fan of the patent system, but "patent system promises spoils for coming up with great new drug, companies comes up with great new drug, companies gets spoils" is exactly how it's supposed to work. Yes, it's sucks that you have to pay, but that's how you incentives getting the wonder drugs invented in the first place. (I have my own take on this, but if anything this is a 'textbook case' in favour of the patent system.)
Eminent domain would still require fair compensation to the company, so you'd have to pay them more or less what they'd lose from not having the patent anymore.
(Though I think the term you might be looking for is 'compulsory licensing' or so? Not sure.)
Depending on how transformative the effects are (and the price drop possible upon genericisation) then there could be a compulsory licensing trade to do here.
The drug companies are presumably pricing optimally for profit (but not for maximum public benefit, for which the optimum price is ~0). You could calculate the net present value of the drug companies' total profits attributable to the patent, add on 10% as a bonus, and pay them off. If the welfare gains of having cheap drugs are genuinely greater than the value of the patent to the holder, this would be win/win.
Citation needed for the idea that zero is the optimal price for public benefit. Among other issues, I expect medication compliance would be higher when the patient has to pay for the medication.
I think we probably have data on that (at least in general). That is assuming people react to out-of-pocket payments, and not to how much their insurance or the NHS etc is paying.
That is exactly what I have in mind. "Eminent domain" doesn't mean just taking things with no recompense, but I don't think the company should be entitled to profit maximization at the expense of literally billions of people worldwide.
If this research was done fully via the public system in the first place, it would be an easier nut to crack. I mean, some of it is already, and that’s the absolute worst scenario: the public paid for it via taxes, and now has to pay for it privately after the fact.
No. Fair compensation means that the company doesn't end up with a loss, and gets rewarded, but it doesn't mean "give them as much money as they could otherwise extract by exploiting the monopoly that the patent gives them on the market".
And withholding access to drugs that would extend everyone's lifespan by several years to maximize profits doesn't seem fair to me either. In fact, it's outright sociopathic.
These drugs are covered for the people whose lifespans would be extended by having them! They pay nothing! The situations where insurers/medicaid don't want to pay are more marginal cases. And even then, it's like, 1/5 the cost of child care in a major metro and only getting cheaper. If you're going to use an extraordinary mechanism to seize private property, it better have outsized impact -- seize surface parking lots and sell them to developers to build more housing.
Patents are a form of artificial monopoly that only exists because the people (acting through their government as a representative of their will) decided to have them, and did so because they presumably are a net social benefit. Consequently, governments are not obligated to treat them as sacrosanct, and most certainly not in a case where they are not beneficial to public interests.
It's a social contract between the people and the enlightened. The people always win on a long enough timeline. But the deal is there should be some sliver of reward for a brief window of time to those who bring permanent light into our lives.
The "enlightened" are the scientists who actually developed this stuff, not the CEOs and corporate shareholders collecting economic rent from other people's hard work who pocket the vast majority of the profits. If we only had to fairly pay the people who actually did the useful work and not all the capitalist deadweight, these drugs would be orders of magnitude cheaper.
And you think scientists should be working for the communists instead of the capitalists? Well that's fine too. Scientists are like spoils of war. Scientists were treated well and able to do a lot of good work when they were all employed by the soviet state. Maybe not as good as the Americans did. They also seem to be doing well over in China. But just because you don't like someone or how they do business, that doesn't make them deadweight, and no I don't think you know how to get products to consumers cheaper.
Let's not assume self‑interested corporate monopoly rents are a necessary precondition for innovation, and let's drop the romanticized notion that statutory patent terms by themselves constitute a just moral bargain, because history shows substantial discovery emerging from publicly funded science, mission driven nonprofits, collaborative consortia, open licensing, prizes, and advance market commitments, so we should test which incentive mixes work rather than presuppose one. Your "people always win on a long enough timeline" line doesn't answer the moral question of avoidable deaths, irreversible morbidity, or financial ruin before expiry; inevitability ≠ adequacy, and harms incurred during exclusivity remain morally chargeable. Commercialization does not require locking invention behind maximal (often crude, lengthy) IP, there are workable paths via milestone or frontloaded prizes, targeted or indication specific exclusivities, compulsory or voluntary licensing, patent buyouts, tiered pricing, and public manufacturing backstops; optimal mixes will and should differ across high‑income vs low and middle income country purchasing power. The "7‑year wait" is factually thin: statutory patent term is ~20 years from filing, while effective market exclusivity depends on regulatory data protections, biologic exclusivities, secondary or evergreening patents, litigation delays, and manufacturing barriers; patients routinely face restricted access even after nominal expiry. We also shouldn't conflate discovery scientists with development firms, nor firms with shareholders; in practice, salaried scientific labor is often alienated from downstream pricing power while financialization channels can parasitically extract surplus that need not translate into new R&D. Because many medicines and virtually all software have low marginal production cost relative to monopoly price, large deadweight losses arise when willing buyers are priced out, a staggering public welfare loss (and no, "deadweight" is not necessarily a synonym for "people you dislike"). Reading int_19h's rent‑extraction critique as a demand for Soviet central planning, and pivoting to talk of scientists as "spoils of war", is a straw man and a red herring that dodges the pricing structure at issue. If you want to defend the patent regime as a "social contract," we need to see the reciprocal side, access safeguards, anti‑evergreening enforcement, affordability commitments, otherwise it's a moral bargain in name only. Claiming membership among the "enlightened" means actually shedding light on these failures.
Noted. Given your 'Go vomit words' reply, I'll keep this short. In the spirit of good will, I'm happy to engage with anyone who wants to discuss the substance of the argument in good faith, including you, if you ever decide to change your mind. And, just as a reminder, there's no need to keep responding unless you're ready for a serious conversation.
Liraglutide isn't fully comparable. On aspect that's a lot touch for many is it's a daily injection. More needles is a turn off for some that can manage 1x/week.
It’s one people need to consider, but it’s one that the people needing it the most won’t do.
It’s a massive problem for several of my friends who are doctors. Patients start on something that works incredibly well for them then their insurance pushes them to Litaglutide and they loose all of their progress.
Some of it comes down to a fear of needles, some of it comes down to non-compliance, some of it comes down to access.
Daily injections are fatiguing on people. Its a big challenge with diabetes management.
I used to be prescribed Victoza (for diabetes). When liraglutide (the generic) went off-patent, every pharmacy reported that both Victoza and liraglutide were "no longer available".
Use stairwaytogray, find a supplier with a history of many many 99+% purity reports from 3rd party testing sent to janoshik, then order 20 vials from that supplier, then either send a vial to janoshik yourself or participate in a group buy test (or just wait for someone else to test the same batch. At that point, it is very likely your ampoules have the same purity and amount. The best supplier seems to currently be sigma audley.
It’s unlikely new meds will be approved this year (unless the FDA really does speed up approval processes)
I made a tool to compare prices: https://www.glpwinner.com/
If you’re on name brand without insurance coverage you’re sitting around $499 a month. On compounded you can get between $150-300 a month. If you live somewhere expensive like the bay and eat out a lot you are likely saving money by being on the medication.
Are there any alternatives coming out soon or generics?