Geneva: The World Health Organization (WHO) has added four major type 2 diabetes (T2D) and obesity drugs to its Essential Medicines List (EML), a move expected to reshape treatment access and market dynamics worldwide.
The Drugs Added
The update includes:
- Semaglutide (Novo Nordisk) – sold as Ozempic (T2D) and Wegovy (weight management)
- Tirzepatide (Eli Lilly) – sold as Mounjaro (T2D) and Zepbound (weight management)
- Liraglutide (Novo Nordisk) – marketed as Saxenda
- Dulaglutide (Eli Lilly) – marketed as Trulicity
These medications belong to the class of GLP-1 receptor agonists (GLP-1RAs) and dual GLP-1/GIP receptor agonists, which have shown strong clinical benefits in managing diabetes, obesity, and related cardiovascular risks.
Affordability Concerns
While recognizing their medical value, WHO raised concerns about cost barriers. In the US, monthly prescriptions for semaglutide and tirzepatide range between $997 and $1,349, potentially limiting access. Trulicity and Saxenda are priced only slightly lower, creating challenges for widespread adoption.
To improve access, WHO has urged health systems to integrate these drugs into primary care while pushing for generic versions to drive down prices.
Market Impact & Generic Competition
Analysts expect the EML designation to:
- Boost demand and broaden usage beyond wealthier populations
- Encourage pharmaceutical companies to speed up global regulatory approvals
- Spur competition from generics, especially as patents begin to expire
Key developments include:
- Teva’s generic Saxenda approval in the US (Aug 2025), which could erode Novo Nordisk’s market share
- Semaglutide facing patent expiry in India, China, Brazil, Canada, and Turkey in 2026
- Trulicity losing exclusivity in 2027
- Tirzepatide (Mounjaro/Zepbound) retaining US protection until 2036–2039
Novo Nordisk’s semaglutide generated $28 billion in global sales in 2024, underscoring the stakes as generic versions loom.
The Bigger Picture
According to WHO experts, listing these drugs as essential medicines could transform diabetes and obesity care globally, shifting them from niche, high-cost treatments to widely available therapies — provided affordability challenges are addressed.
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