Inside South Africa’s fast-changing market for weight‑loss injections

What has shifted in the market

Medicines originally developed for type 2 diabetes including semaglutide and tirzepatide products such as Ozempic, Wegovy and Mounjaro have moved into wide use for weight loss over the past two years. This has driven a surge in demand, a rise in private obesity clinics and growing public interest fuelled by social media.

New competition from generics and authorised low‑cost products

The expiry of several semaglutide patents in South Africa has opened the door to generics. Recent developments cited by regulators include Sun Pharma receiving SAHPRA approval for a generic semaglutide injection, and Novo Nordisk announcing a lower‑priced authorised version of Ozempic called Extensior. SAHPRA confirmed it is reviewing 12 additional semaglutide applications from various manufacturers.

Experts quoted in the original reporting warned that while increased competition typically leads to lower prices, meaningful reductions may take time as manufacturers establish supply chains and pharmacies negotiate pricing.

Access, affordability and who is currently able to get treatment

Affordability remains the principal barrier to wider access. Monthly treatment costs can be high, and most medical schemes provide only limited reimbursement often when medicines are prescribed for diabetes rather than for obesity. As a result, the market has been largely restricted to privately insured or affluent patients, while most South Africans remain unable to access these treatments.

Health policy researchers have argued that these medicines could become relevant in the public sector only if prices fall substantially and evidence shows long‑term cost savings, alongside national guidelines and budgetary provision.

Regulatory crackdown on compounded products

Regulators have taken action against commercial‑scale compounding of GLP‑1 medicines. The South African Health Products Regulatory Authority (SAHPRA), together with the South African Pharmacy Council, has ordered recalls of compounded GLP‑1 products; seized products containing semaglutide and tirzepatide; warned healthcare professionals about prescribing unregistered medicines; and pursued enforcement action against companies producing compounded versions.

Authorities say patients cannot be certain that compounded products meet correct active‑ingredient, strength or sterility standards. Manufacturers of some compounded products dispute those allegations and legal challenges are ongoing.

Which products are registered and for what

As of July 2026, the following registration situation was noted:

• Ozempic is registered for type 2 diabetes and is commonly prescribed off‑label for weight loss.
• Wegovy is registered specifically for chronic weight management.
• Mounjaro has approvals linked to diabetes and, more recently, chronic weight management.
• Saxenda remains another approved obesity medicine, though its daily injections have been largely overshadowed by newer weekly medicines.

SAHPRA continues to remind patients that medicines should be used only according to approved indications or under qualified clinical supervision.

What to expect next

Industry observers and regulators expect the next 12 months could significantly reshape the market as generics and authorised lower‑cost products reach pharmacies and as SAHPRA continues to review applications. Regulators also stress that prescriptions should come through legitimate healthcare providers and caution patients to avoid unregistered or illegally compounded products sold online or through unofficial channels.