As regulatory action closes the door on illegally compounded GLP-1 weight-loss medicines, affordability could become the next major hurdle for South Africans seeking medically supervised weight management.
For thousands of South Africans who have turned to GLP-1 medicines to help manage their weight, the options may be becoming narrower – and more expensive.
Recent regulatory and legal action against pharmacies illegally compounding GLP-1 weight-loss medicines has affected up to 300,000 South Africans, according to Obiflex.
With the compounded route now closed, the concern is that people who cannot afford registered medicines may look elsewhere.
The appetite for GLP-1 weight-loss treatment in South Africa is estimated at around R3 billion, highlighting the scale of demand.
The dilemma is straightforward: pay for registered, doctor-prescribed treatment that can cost thousands of rand a month, or risk turning to unregulated and potentially unsafe alternatives.
The affordability problem
Registered GLP-1 medicines typically cost between R3,000 and R6,000 a month, excluding doctor consultations.
Medical aid cover is also limited. According to Obiflex, most schemes contribute around 50% of the cost for members who have a diabetes diagnosis, leaving people using the medicines for weight management for other reasons to fund treatment themselves.
That price difference has been one of the factors driving consumers towards cheaper compounded products.
“Affordability pushed so many patients toward cheaper, unregistered compounded alternatives,” says Shaun Barns, co-founder and CEO of Obiflex.
“Now the compounding route has been shut down by the South African Health Products Regulatory Authority (SAHPRA) and South African Pharmacy Council (SAPC), so unless there’s legitimate, affordable access, that demand doesn’t disappear; it risks people seeking other unregulated or illicit options.”
For consumers, the issue is therefore not simply whether GLP-1 medicines are available. It is whether people can realistically afford to access them through legitimate medical channels.
Could a buy-now-pay-later model make GLP-1s more accessible?
Obiflex, a doctor-led health management programme, is attempting to address that affordability gap with a payment model that spreads the cost of treatment over several months.
Its three-month programme is divided into five monthly payments of R1,499, while its six-month programme is divided into nine monthly payments of R1,999.
Both programmes include a virtual doctor consultation, virtual health coaching, digital health tracking tools, weekly wellness advice and door-to-door delivery.
The service can be accessed through WhatsApp or the web, without requiring members to download a new app.
The company describes the model as a form of buy-now-pay-later (BNPL) access to GLP-1 treatment, aimed at making the monthly financial commitment more predictable.
Medical oversight is part of the programme
Obiflex says its doctor network has been specifically trained in the endocrinology and cardiology of weight management by co-founder Dr Riaz Motara.
According to the company, doctors are trained to look beyond the number on the scale and address some of the underlying factors associated with unhealthy weight changes.
The programme combines low-dose GLP-1 treatment with structured health coaching, including guidance around nutrition, sleep and movement.
The company says targeted weight loss through the programme is up to 10% of body weight over six months, with members able to continue with further treatment if they require additional support.
Weight management can be complex, and medication is only one component. Obiflex’s model is therefore designed to combine medical supervision with ongoing lifestyle support rather than relying on medication alone.
What happens when affordability drives people outside the healthcare system?
The growing demand for GLP-1 medicines has created a parallel market, including products obtained outside established medical and pharmacy channels.
That creates concerns around product quality, authenticity, appropriate dosing and the absence of medical supervision.
For people already looking for weight-loss solutions, removing one lower-cost route does not necessarily remove the underlying demand.
“There are hundreds of thousands of South Africans who want to better manage their weight, and many of them have been doing so through unregulated channels,” says Barns.
“Obiflex believes that if someone has already chosen to make health changes, we should make sure there’s an affordable, safe, legitimate approach with medical oversight.”
The distinction between affordability and safety is important. Lower cost does not necessarily mean lower risk, while registered treatment can remain inaccessible if the price is beyond a person’s budget.
More than just the medication
Obiflex says it deliberately designed its programme around more than access to GLP-1 medication.
Members receive weekly wellness content covering nutrition, sleep and movement, as well as access to health-tracking tools that monitor body composition, blood pressure and other vital measurements.
One-on-one health coaching is also available to members who want more intensive support, at an additional fee.
“We didn’t want to just make the medicine more affordable,” says Barns.
“We want to offer proper medical support, coaching and a way to pay for GLP-1s.”
The company has also partnered with a pharmaceutical company it describes as a pioneer in weight-loss medication and one of the world’s largest pharmaceutical companies.
A changing weight-loss landscape
The regulatory crackdown on illegally compounded GLP-1 medicines comes at a time when demand for prescription weight-loss medication is growing both internationally and in South Africa.
For consumers, the challenge is increasingly about navigating the space between demand, cost and medical oversight.
The message from Obiflex is that shutting down unregulated access needs to be accompanied by legitimate options that consumers can afford.
For anyone considering a GLP-1 medicine, however, the decision should begin with a qualified healthcare professional. Prescription weight-loss medicines are not suitable for everyone, and treatment should be based on an individual’s medical history, health needs and appropriate clinical assessment.
As the South African GLP-1 market continues to develop, affordability is likely to remain an important part of the conversation.
Obiflex is available across South Africa.
