GLP-1 drugs like semaglutide (sold as Ozempic and Wegovy) are so successful that they have redefined what the pharmaceutical industry calls a “blockbuster”. Few prescription drugs have moved from regulatory approval to mass adoption so quickly. First approved for the treatment of diabetes, they were soon recognized and sought out for their weight loss effects. Surveys suggest about 12.4%, or one in eight Americans report using a GLP-1 drug for weight loss, up from 5.8% in just two years. Globally, spending on GLP-1s is expected to triple from $50-60 billion today to more that $135 billion within the next decade, with most of those sales expected in North America.
In the United States, lower-cost generic equivalents are still several years away. Canada, however, may see generic semaglutide as early as 2026 following what looks like an unintentional patent lapse. Meanwhile, many Americans have turned to compounding pharmacies to obtain cheaper GLP-1s, a pathway the Food and Drug Administration is now moving to shut down.
The Impact of GLP-1s
Widespread GLP‑1 use is having more than individual effects. With this scale of use, they’re measurably changing consumer behaviour, business strategies, and even economic forecasts. Goldman Sachs estimated US GDP could be boosted by 0.4% through productivity gains and healthcare savings. People that use GLP‑1 drugs are reducing grocery spending by around 5% and buying fewer processed snacks and desserts. Smaller portions and more products with protein and fibre are coming. It may be that GLP-1 drugs may promote reduced alcohol intake as well. We may only now be starting to see the bigger impacts of these popular, effective drugs.
Generic semaglutide is coming to Canada
I consider Derek Lowe’s blog a must read and his post on semaglutide last June was jaw-dropping. He describes an apparent decision by Ozempic/Wegovy’s manufacturer, Novo Nordisk to stop paying their annual patent fee in Canada, which led to the patent lapsing:
I posted this on my BlueSky account and a follower there (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”.
The Canadian patent lapsed on January 4, 2026. Multiple manufacturer plan to bring generic versions forward in Canada, and they’re expected later this year. Given the popularity and cost, the arrival of lower-priced generics is expected to be welcomed by Canadians.
No generics for Americans – anytime soon
There are no FDA‑approved generic versions of semaglutide or of any other GLP-1 drug. These drugs can cost up to $1000/month, making them difficult to afford for all but the very wealthy. While there are expectations and hopes that list prices will drop in 2026, this has not stopped an explosion of unapproved GLP-1 sales, offered by compounding pharmacies. Currently anything being offered as a generic is either a compounded drug, or it could come from an unapproved source (e.g., imported).
While a shortage of semaglutide and tirzepatide enabled compounding pharmacies to legally manufacture these products, the restoration of full supply has closed the door on legal compounding. However, some compounding pharmacies are continuing to produce products.
Compounding is the process by which a pharmacy can create a customized drug product that addresses unique patient needs, such as allergy, or dosage form requirements. But importantly, compounded drugs are not subject to FDA approval, and finished products are not reviewed for safety, efficacy, or quality. Risks of harms are consequently higher with compounded products, so they should be avoided when an FDA-approved product is available. Compounding was never intended to be for mass production, or as a way of circumventing intellectual property laws.
For price-sensitive Americans eager to get access to low cost GLP-1s, these advertisements are likely tempting: If you can’t afford Ozempic, why not buy what’s advertised as “generic semaglutide” from a telehealth company that ships it to your door? The FDA has repeatedly warned that some compounders are using different salt forms of semaglutide, unverified active ingredients, or multi‑dose vials and concentrations that have already led to serious dosing errors and hospitalizations.
In its March 2026 enforcement action against 30 telehealth companies, the FDA emphasized thats that compounded GLP‑1s are unapproved and are not generics. One letter notes,
Compounded drug products are not FDA-approved. Your claims imply that your products have been FDA-approved or otherwise evaluated for safety and effectiveness when they have not. As a result, these claims are false or misleading and your products are therefore misbranded under sections 502(a) and 502(bb) of the FDCA [21 U.S.C. §§ 352(a) and (bb)].
The introduction or delivery for introduction into interstate commerce of these misbranded products is a prohibited act under section 301(a) of the FDCA [21 U.S.C. § 331(a)]. The representations and claims identified in this letter put you on notice of our concerns but do not represent an exhaustive list of violations.
For the reasons discussed above, your compounded semaglutide and tirzepatide products are misbranded drugs under sections 502(a) and 502(bb) of the FDCA [21 U.S.C. §§ 352(a) and 352(bb)], introduced or delivered for introduction into interstate commerce in violation of section 301(a) of the FDCA [21 U.S.C. § 331(a)]. Please be advised, the receipt in interstate commerce of misbranded drugs, and the delivery or proffered delivery thereof, is also a violation of section 301(c) of the FDCA [21 U.S.C. § 331(c)].
Conclusion: Generics for some
GLP‑1 drugs are highly effective therapies addressing a genuine health need. They are generally well tolerated and are having meaningful, population-level effects on obesity. Unfortunately, that demand has run up against high prices, and an illicit grey market has appeared as a result. While US prices are expected to drop somewhat in 2026, the Canadian market may give a preview of what Americans can expect in several years: Regulator-approved, low-cost generic equivalents that make GLP-1 drugs accessible and affordable.
Scott Gavura, BScPhm, MBA, RPh is committed to improving the way medications are used, and examining the profession of pharmacy through the lens of science-based medicine. He has a professional interest is improving the cost-effective use of drugs at the population level. Scott holds a Bachelor of Science in Pharmacy degree, and a Master of Business Administration degree from the University of Toronto, and has completed a Accredited Canadian Hospital Pharmacy Residency Program. His professional background includes pharmacy work in both community and hospital settings. He is a registered pharmacist in Ontario, Canada.
Scott has no conflicts of interest to disclose.
Disclaimer: All views expressed by Scott are his personal views alone, and do not represent the opinions of any current or former employers, or any organizations that he may be affiliated with. All information is provided for discussion purposes only, and should not be used as a replacement for consultation with a licensed and accredited health professional.