[mjamil]

Given that it costs NN ~$5 to manufacture, and it's an effective drug that's an also-ran in the market, why still charge such a huge markup? NN should be selling it for $35-$50/month and buy the market share while feverishly working on a multi-GLP1 replacement.

[toomuchtodo]

They are milking the market up until the patent expires in Canada next year, at which point it’ll be imported into the US at scale. Novo’s already been beaten by Lilly with tirzepatide and orforglipron.

(I pay $350/month cash rate for my partner’s monthly tirzepatide)

https://investor.lilly.com/news-releases/news-release-detail...

How Ozempic's maker lost its shine after creating a wonder drug - https://news.ycombinator.com/item?id=44942077 - August 2025

[wpm]

Is that $350/mo for the starter dose or higher?

[toomuchtodo]

2.5mg starting dose, which is also their maintenance dose.

[dkiebd]

Wait, you need a higher dose as time goes on?

[soegaard]

The US list prices are, well, a complicated matter. For non-US readers, it is important to note that 80% of the customers (who has insurance) don't pay the list price, but rather an much more reasonable over-the-counter price.

Due to the system of insurance companies and PBMs in the US the list price is often high.

When PBMs a are negotiating with the pharmaceutical companies, they have an incentive to keep a high list price. Let's say the PBMs and a pharmaceutical company negotiates for the price of a drug X.

If the pharmaceutical company lowers the price of the drug X, and there are other comparable drugs from other companies on the market, then there is a risk that the PBM simply drops the drug X from their lists. Instead, they make a better deal (for them) on drug Y.

For the company producing X, being omitted from the insurance companies lists, is bad business.

As an outsider, it is difficult to understand that the US keeps the private insurance layer and the PBMS.

Now - the insurance companies also don't pay list prices. They get a rebate. But they - and here my memory fails me - the get some money from ... the government based on the list price.

Look at the congress hearings on the high medicine prices on YouTube.

[phonon]

Maximizing profits until retatrutide comes out and blows the whole market open.

[blacksmith_tb]

Still sub-cutaneous, though? I would think whatever GLP-1 agonist that's oral-route will crush all of the competition instantly?

[phonon]

Well, oral will be less effective (not a triple agonist like retatrutide) and might have greater side effects (the dose is larger since it goes through your digestive system) and you have to take it daily. But in any case, that will further box out semaglutide. Of course Novo has its own drug pipeline, but not clear if any of them are better than (or even equal to) retatrutide.

[haebom]

When will Retatrutide release to the market?

[phonon]

Assuming the phase 3 trials are successful, probably late '26 or early '27.

[haebom]

Before that, I'll have to sell all my NN shares.

[hulitu]

As the title says: "eligible US cash-paying customers". So cash milking citizens. /s