The FTC Has the Chance to Rein in Big Pharma
Semaglutide manufacturers seem to be taking advantage of America’s health crises to indulge in anticompetitive behavior.
The Federal Trade Commission needs to keep a watchful eye on Big Pharma’s recent maneuvers to control necessary medicine. Indeed, large pharmaceutical companies are seizing our growing diabetes and obesity crises as an opportunity to cash in on American patients. How? They are attempting to manipulate the production of semaglutide—the primary ingredient in Ozempic and Wegovy—probably because of the undeniable pecuniary success European Big Pharma companies, like Novo Nordisk, are seeing from those sales. Indeed, Ozempic sales in the U.S. were roughly $13.9 billion in 2023. Novo Nordisk itself reported that it experienced an increase of 58 percent in GLP-1 diabetes sales and a 154 percent rise in obesity care sales, largely credited to Ozempic and Wegovy’s distribution.
One primary issue is that the GLP-1 market is almost entirely made up of one of two manufacturers, Lilly and Novo Nordisk. These two companies control almost the total supply of GLP-1 medications. Conservative estimations indicate that Lilly enjoys at least a 56 percent market share in GLP-1 subscriptions. Novo Nordisk makes up the remaining 44 percent.
Given these drugs’ essential role in managing our ongoing diabetes and obesity crises, we can’t be overly reliant on two supply chains, especially when just under half of it is owned by a non-American company, namely Novo Nordisk. When one of these firms makes an economic decision, such as engaging in exclusive dealings or changing prices, it sends a sonic boom throughout the market both for consumers and competitors.
It is why the Trump administration must stay vigilant of Big Pharma’s tactics to harness control over our medicine so that the MAHA agenda can be realized fully.
It is also why Lilly’s recent deals with telemedicine providers is so troubling. On June 10, 2025, high-level officials at Lilly offered remarks at Goldman Sachs’s conference. According to readouts from Lilly’s presentation, the company described the measures it is undertaking to “reduc[e] patient out-of-pocket costs” and how it plans to “enhance[e] direct-to-consumer experiences.”
Concerningly, the company made a slew of admissions throughout its presentation that raise the specter of anticompetitive behavior. It described how it is engaging in exclusive contracting with telehealth providers, how it may be leveraging the prevention of compounding to create barriers to generic access of GLP-1 drugs, how it is using its brand dominance to fortify pricing power, and how it uses its Lilly Direct as a tool to divert users to its services by exerting even more control over GLP-1 distribution.
But this is far from the only issue.
Novo Nordisk’s recent decision to cut ties with Hims has also sent a rippling effect through the market. Indeed, due to the partnership ending, Hims shares dropped a whopping 32 percent. The drop in shares after a deal falling through is not abnormal. However, the given reason as to why the deal has is. Novo is using a regulatory designation by the Food and Drug Administration (FDA) to prevent Hims from selling a generic alternative to its Wegovy because Novo contends that such sales are now illegal due to the FDA removing semaglutide—the active ingredient in Wegovy, Ozempic, and Rybelsus—from its “shortage list.”
What makes this claim strange is that Novo Nordisk did not just want to prohibit the sales of doses within the legal parameters of the FDA rules, but even offerings where the rules likely did not apply. Specifically, Novo Nordisk was forcing Hims to stop the distribution of “personalized” doses of semaglutide compound drugs that providers were prescribing to their patients. The FDA rules are fairly clear that the providers make that decision, not the pharmaceutical company. Indeed, Section 503a of the Federal Food, Drug, and Cosmetic Act allows health providers to make the choice on whether a particular patient requires a personalized dose via a compound, even when no shortage exists.
Hims, however, claims that Novo Nordisk is arbitrarily using that designation to pressure the company into steering patients to its branded drugs as opposed to offering them a compounded (and more affordable) option. In short, Novo wants to take that choice out of the provider’s—and by extension the patient’s—hands, with no apparent legal basis.
These reasons alone are enough to spark at least an investigation to get a clearer picture of what these dealings entail and their potential to have anticompetitive effects. As FTC Commissioner Mark Meador observed, there is an expressed “need for continued vigilance over competition in the healthcare space.”
The FTC opening up an investigation into Lilly and Novo Nordisk’s practices would be precisely that.
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