Illustrative image: Generated with Google Gemini Flash Image 2.5 You might have recently found yourself in the quite strange position of learning that more than one or two people in your life are suddenly making important progress in what for many is an ongoing battle to control their weight.
I’ve mentioned before that it can put you in a slightly difficult social position.
You may be about to find out how they’ve done it.
On Monday the High Court in Tshwane granted an interim ruling in favour of the international pharmaceutical giant Novo Nordisk preventing the compounding pharmacy iDexis from continuing to produce and sell its versions of Wegovy and Ozempic.
This ruling is temporary, there is a lot more money for the lawyers to make before anyone has any clarity on what is really going to happen.
I was staggered to learn how big this operation is. Novo Nordisk says iDexis was selling 85,000 medication pens every month.
To appreciate the scale of that, that’s more than both Novo Nordisk and Aspen (which distributes Mounjaro) are selling in our market.
Now, I suspect many people who had been getting their product from iDexis might battle to continue with it (if you’re curious, they also trade as “Sentra”, so if you see that name on a medicine pen near you the supply may soon run out).
While the ruling came through on Monday, it’s one of those moments when all of the people concerned take a little while to chat to the legal people, strategise with PR and generally line up their ducks.
So it was only last night that iDexis MD Ruaan Louw (he is also the only shareholder, so presumably is the owner of iDexis) gave his first interview about the loss to The Money Show.
His line was interesting.
He says that we should “ask what’s more important… the commercial interests of certain groups or access to safe and tested medicine”.
It reminded me a little of the huge fight in which our government was involved in about 2000, when pharmaceutical groups tried to stop us from using generics for ARVs.
I was living in London at the time so I only watched it from afar. But I have a strong memory of the report from the BBC’s Newsnight television programme that featured their economics reporter in Joburg. At one point they just filmed him in the reception area of one of the big pharmaceutical companies, lingering over the well-fed goldfish living their best life in a pond alongside the marble of the reception area.
It was one of those moments where a picture said so much more than a whole decade’s worth of financial statements.
Louw also says that these drugs were first developed to help diabetics, and as one himself, he knows how important they are.
So, all of that is true. And it’s tempting to get out of the violins and talk about how we should back the course of truth and justice and all the rest of it.
But this is not what the law says.
As I understand it, the active ingredients in the drugs iDexis is selling are not formally registered with the SA Health Products Regulatory Authority. So, what exactly are they making?
And this is really the point. I suspect what this is really going to be about is what is the line between “compounding” a drug, where you mix it into a different form for a customer with a prescription (think of putting two different lotions together for a skin complaint), and actually creating a drug.
And, as things stand, the people who own the drugs, those who developed them, own them.
And while we could argue that no one can “own” knowledge, the fact is that this is how the industry works, and has worked for a very long time.
If we don’t accept that, it means that anyone can take apart any drug and recreate it and sell it. And that would be the end of innovation.
I also have to say I also find the South African Health Products Regulatory Authority’s (Sahpra) findings, after their raid on the iDexis factory, really important. They said the factory was manufacturing these drugs in an unsafe environment.
Louw is furious at this claim and says he doesn’t understand why Sahpra had to use armed guards in their raid. While my life experience has had interesting moments, I have never been on a dawn raid on a pharmaceutical factory before, so I can’t tell you if that’s normal practice.
What I can tell you is that the companies that developed these drugs have spent billions of dollars on them and know how valuable they are. And while generics are coming, they will do everything they can to stop the copycats.
The incentive for the copycats is massive too. I will be surprised if Louw and Novo Nordisk don’t find themselves in the Constitutional Court before this is all over.
In the meantime, if you notice someone suddenly backsliding in their fight against weight, my social advice would be to show as much love and support as possible.
But tread carefully. And don’t draw attention to it. DM