Section I -- The Arithmetic

A class of drugs called GLP-1 receptor agonists has become the most commercially significant pharmaceutical development in a generation. The most prominent of these -- semaglutide, sold as Ozempic for diabetes and Wegovy for weight loss -- treats conditions affecting hundreds of millions of people worldwide.

In April 2024, researchers at Yale School of Medicine, in partnership with Doctors Without Borders, published a study calculating the actual cost of manufacturing these drugs. They added up the cost of every component and every process that goes into production. The estimated cost of producing a month's supply of semaglutide: between $0.89 and $4.73.

The list price of a month's supply of Ozempic in the United States: $968.52.

The Bureau wishes to ensure the reader has absorbed this correctly. The molecule costs less than a dollar to manufacture. It is sold for nearly a thousand. The markup is not a rounding error. It is the business model.

In 2024, Novo Nordisk -- the Danish company that manufactures semaglutide -- generated approximately $26 billion in revenue from Ozempic and Wegovy combined. A single compound accounted for nearly 70 percent of the company's total revenue. American consumers provided more than 71 percent of the company's obesity-drug sales.

A substance that costs $0.89 to produce generated $26 billion in one year. The Bureau notes that this is not a pharmaceutical margin. It is a pricing architecture.