1. From Gut Hormone to “Wonder Drug”
If you strip away the hype, semaglutide is simply a clever copy of a natural hormone that tells the body “you’ve eaten enough.”[1]
In the 1980s and 1990s, researchers discovered that the gut hormone GLP‑1 could lower blood sugar, slow digestion and curb appetite, but the natural hormone disappeared from the body within minutes.[2][3]
So Novo Nordisk chemists spent years “armouring” GLP‑1—tweaking its structure so it survived longer in the bloodstream and could be given as a weekly injection instead of a constant drip.[4][5]
One of those tweaked versions was semaglutide, designed to stay active for around a week, which made it practical for real‑world use in diabetes and, later, obesity.[6][7]
Key point: A basic hormone signal from the gut was turned, step‑by‑step, into a long‑acting drug molecule that could be injected once a week.
2. How Semaglutide Became Ozempic, Wegovy and Rybelsus
Once the molecule was ready, the business story began. Semaglutide is the same core drug behind three global brands:[8][3]
- Ozempic (injectable) – approved in 2017 for type 2 diabetes, once‑weekly injection.[9][3]
- Wegovy (higher‑dose injectable) – approved in 2021 for chronic weight management, using larger doses of the same drug.[10][11]
- Rybelsus (oral tablet) – an oral version of semaglutide, approved around 2019 for diabetes.[3][8]
Clinically, the trials showed strong reductions in HbA1c and substantial weight loss versus older diabetes drugs and earlier weight‑loss pills.[12][13]
Commercially, each brand got its own positioning, campaigns and, importantly, slightly different regulatory labels and patent “wrapping.”[14][15]
Key point: One discovery was sliced into multiple brands and indications, each with its own story, price and protection.
3. How Much Money Are We Talking About?
To understand why semaglutide dominates headlines, just follow the money.
- The global semaglutide market (Ozempic, Wegovy, Rybelsus and others) was worth about 28–29 billion USD in 2024 alone.[16][17][18]
- Market analysts project it could reach around 90–94 billion USD per year by 2035 in a base‑case scenario.[15][18][16]
Given these annual numbers, cumulative worldwide sales from launch (2017) to now easily run into many tens of billions of dollars, and over its full commercial life semaglutide is on track to become one of the most lucrative drug franchises in history.[17][18][15]
Key point: Semaglutide is not just a blockbuster; it is a multi‑brand franchise on course for 100‑billion‑dollar‑plus lifetime sales.
4. Evergreening: What the Delhi High Court Just Called Out
For a common reader, “evergreening” can sound abstract, so think of it like this:
You own a valuable piece of land (the original patent).
As the lease end approaches, you build small sheds, fences and flower beds (new patents on formulations, devices, minor tweaks) and argue that each one needs its own long lease.
In semaglutide’s case:
- Novo Nordisk obtained a “genus” patent covering semaglutide as a compound, with the usual 20‑year protection.[19][20]
- Later, it filed a second patent on a closely related version intended to prolong exclusivity, along with a series of secondary patents on formulations and delivery devices.[21][14]
- The Delhi High Court, examining Novo’s suit against Indian companies like Dr Reddy’s, held that this second patent amounted to double patenting and “evergreening”, which is barred under India’s Patents Act (Section 3(d)).[20][22][19]
Because India explicitly prohibits evergreening, the court refused to block Indian firms from manufacturing and exporting semaglutide while maintaining restrictions on in‑country sales tied to remaining patent issues.[23][20]
Key point: Courts in India have openly described parts of Novo’s semaglutide strategy as evergreening—extending monopoly protection beyond what a single invention normally deserves.
5. The Business Playbook – Explained for Non‑Insiders
Semaglutide is a master‑class in how big‑ticket drugs are managed globally. At a simplified level, the playbook looks like this:
5.1 “One Big Bet” → “Many Cash Flows”
- Drug discovery is expensive and risky: thousands of molecules are screened; only a handful reach patients.[24][4]
- When one “hits” like semaglutide, the company does not stop at a single product; it builds a franchise—diabetes, obesity, heart disease, kidney disease, NASH, etc.—each indication creating new revenue streams.[13][25][2]
5.2 Branding and Segmentation
- Ozempic is sold as a diabetes drug, Wegovy as a specialist obesity treatment, and Rybelsus as a convenient oral option; the science is similar, but the marketing language and price points differ.[26][10][8]
- This allows differential pricing and targeted campaigns: employers, payers and governments may pay more for weight‑loss or “cardio‑protective” positioning than for plain glucose control.[18][15]
5.3 Patent Fences and Legal Strategy
- Around the original patent, firms file patents on pens, dosing regimens, combinations and small formulation changes, creating a thicket that generic manufacturers must fight through.[27][14]
- In “evergreening‑friendly” countries, this can delay generics by years; in countries like India, stricter law and active courts can cut these fences down earlier.[22][20]
5.4 Global Pricing and Access Management
- High‑income markets (US, EU, some Gulf countries) bear the highest list prices and drive most of the profit.[17][18]
- Middle‑income countries often see delayed launches, tight quotas or premium pricing, as companies try to avoid price erosion leaking back into rich markets through reference pricing.[28][18][21]
Key point: The science may be global, but the business model is finely tuned country by country—using brands, patents and pricing to stretch the profitable life of the molecule.
6. How Patients Gain – and How They Get Hurt
6.1 Clear Benefits
- Semaglutide can significantly reduce blood sugar, promote weight loss of 10–15% or more of body weight in many patients, and lower the risk of heart and kidney complications in high‑risk groups.[12][13][3]
- For many people with diabetes and obesity, that translates to fewer heart attacks, less disability, and potentially longer, healthier lives.[1][3]
6.2 Real Harms and Trade‑offs
- Affordability and access: At current prices, long‑term semaglutide therapy is out of reach for most patients worldwide without strong insurance or public‑health support.[18][28]
- Crowding out budgets: When a single class of drugs consumes a big chunk of health budgets, other areas—vaccines, primary care, older but useful drugs—can get squeezed.[29][18]
- Evergreening delays generics: By keeping cheaper competitors out, evergreening keeps prices high for longer, meaning millions of patients either delay treatment or never start it.[14][19][22]
- Safety and hype cycles: Rapid, celebrity‑driven uptake can outpace long‑term safety data, leaving regulators and courts to deal with adverse‑event litigation years later, as seen in emerging lawsuits.[25][13]
Key point: The same system that produces life‑changing drugs can also keep them scarce, expensive and unevenly distributed.
7. Why the Semaglutide Story Matters for India
For India—and by extension, countries that look to India for affordable generics—the semaglutide saga is a live case study.
- Indian courts have reaffirmed that Section 3(d) is not a decorative clause; it can and will be used to strike down evergreening attempts, even in the face of massive global brands.[19][20][22]
- Indian manufacturers have been allowed to manufacture and export semaglutide generics, positioning India as a future hub for cheaper GLP‑1 therapies once key patent barriers fall.[23][20]
- How regulators manage quality, safety monitoring and ethical promotion will decide whether India offers a credible “access‑friendly” alternative to the current high‑price, high‑hype model.[28][23]
Key point: Semaglutide is not just a molecule; it is a test of how far India—and the world—can go in balancing innovation rewards with the right to affordable treatment.
Sources – Copyright of all images acknowledged in sources.
[1] How does semaglutide work: Wegovy and Ozempic … https://www.faynutrition.com/post/how-does-semaglutide-work-wegovy-ozempic
[2] The discovery and development of GLP-1 based drugs that … – PNAS https://www.pnas.org/doi/10.1073/pnas.2415550121
[3] Semaglutide – StatPearls – NCBI Bookshelf https://www.ncbi.nlm.nih.gov/books/NBK603723/
[4] The Discovery and Development of Liraglutide and Semaglutide https://pmc.ncbi.nlm.nih.gov/articles/PMC6474072/
[5] Discovery of the Once-Weekly Glucagon-Like Peptide-1 (GLP-1 … https://pubs.acs.org/doi/abs/10.1021/acs.jmedchem.5b00726
[6] Semaglutide – Wikipedia https://en.wikipedia.org/wiki/Semaglutide
[7] Semaglutide – Proteopedia, life in 3D https://proteopedia.org/wiki/index.php/Semaglutide
[8] The Difference Between Ozempic, Wegovy & Rybelsus https://www.universityhealth.com/blog/weight-loss-medication
[9] How Long Has Semaglutide Been Around? | Ro https://ro.co/weight-loss/how-long-has-semaglutide-been-around/
[10] The Ozempic Era https://www.musc.edu/content-hub/news/2024/08/29/the-ozempic-era
[11] What is the history and development background of Wegovy? https://www.slimtransformation.co.uk/post/what-is-the-history-and-development-background-of-wegovy
[12] Wegovy (semaglutide): a new weight loss drug for chronic … https://pmc.ncbi.nlm.nih.gov/articles/PMC8717485/
[13] Science’s 2023 Breakthrough of the Year: Weight loss … https://www.science.org/content/article/breakthrough-2023
[14] The Semaglutide Patent Puzzle: Evergreening and the Uphill Battle for Indian Generics Post-2026 https://www.linkedin.com/pulse/semaglutide-patent-puzzle-evergreening-uphill-battle-indian-arya-zo5sc
[15] Semaglutide (Ozempic, Wegovy, Rybelsus) Market Trends https://www.globenewswire.com/news-release/2025/05/22/3086357/28124/en/Semaglutide-Ozempic-Wegovy-Rybelsus-Market-Trends-Analysis-and-Growth-Report-2025-2035-Emerging-Markets-and-Oral-Formulations-Present-New-Frontiers-for-Expansion.html
[16] Semaglutide Market Size, Share & Trends Analysis Report By Product (Ozempic, Wegovy, Rybelsus), By Application (Type 2 Diabetes Mellitus, Obesity), By Route Of Administration, By Distribution Channel, By Region, And Segment Forecasts, 2025 – 2035 https://www.marketinsightsresearch.com/marketreports/12/56445/semaglutide-market
[17] Semaglutide Market Size, Share, Opportunity, Growth, 2034 https://www.polarismarketresearch.com/industry-analysis/semaglutide-market
[18] Regional Insights https://www.grandviewresearch.com/industry-analysis/semaglutide-market-report
[19] Semaglutide Patent Clash: Delhi HC Denies Novo Nordisk … https://medicaldialogues.in/news/industry/pharma/semaglutide-patent-clash-delhi-hc-denies-novo-nordisk-injunction-manufacturing-by-dr-reddys-to-continue-160077
[20] Why Delhi HC rejected semaglutide patent suit https://visionias.in/current-affairs/upsc-daily-news-summary/article/2025-12-06/the-indian-express/science-and-technology/why-delhi-hc-rejected-semaglutide-patent-suit-1
[21] Novo Nordisk India strategy suffers semaglutide patent setback | Asia https://www.lifesciencesipreview.com/asia/novo-nordisk-india-strategy-suffers-semaglutide-patent-setback
[22] Knowledge Nugget: Evergreening in Patents—Why Delhi HC’s semaglutide ruling matters for your UPSC exam https://indianexpress.com/article/upsc-current-affairs/upsc-essentials/knowledge-nugget-evergreening-patents-semaglutide-novo-nordisk-10408802/
[23] Delhi HC Allows Dr Reddy’s to Manufacture and Export Semaglutide … https://lawbeat.in/news-updates/delhi-hc-allows-dr-reddys-to-manufacture-and-export-semaglutide-rejects-novo-nordisks-injunction-plea-1544605
[24] [PDF] Discovery and Development of Semaglutide – Semantic Scholar https://pdfs.semanticscholar.org/c290/085c1939cdad50f34806a90df90df659f19b.pdf
[25] Semaglutide (Ozempic, Wegovy, Rybelsus) Market Size, Share … https://www.businesswire.com/news/home/20250523417463/en/Semaglutide-Ozempic-Wegovy-Rybelsus-Market-Size-Share-Trends-Analysis-Report-2025-2035-Competitive-Analysis-of-Novo-Nordisk-Eli-Lilly-Viking-Therapeutics-Lexicon-Biocon-and-AstraZeneca—ResearchAndMarkets.com
[26] Wegovy vs Ozempic: Know the Difference, Benefits & Side … https://pharmeasy.in/blog/wegovy-vs-ozempic-differences-uses-dosage-side-effects-and-more/
[27] Here’s Your Latest Patent and Litigation Update on Semaglutide https://spicyip.com/2025/08/gauging-the-weight-of-the-matter-heres-your-latest-patent-and-litigation-updates-on-semaglutide.html
[28] Semaglutide (Ozempic) Guide for Indian Patients https://www.mrmed.in/health-library/diabetes/ozempic-semaglutide-benefits-risks-india
[29] Ozempic Now a Major Player on the Diabetes Drug Market https://www.statista.com/chart/35435/revenue-diabetes-medication/
[30] How Long Has Semaglutide Been Around? https://www.forhers.com/blog/how-long-has-semaglutide-been-around
[31] Semaglutide Market Share, Size & Growth Outlook to 2030 https://www.mordorintelligence.com/industry-reports/semaglutide-market
