The Struggle Between Public Good and Private Rights Tests Our Commitment to Health Equity
Connecticut’s bold move on GLP-1 generics invites a long-overdue question: When is it time to prioritize lives over licensing?
There is a reason patent law exists. It protects invention. It rewards risk. It fuels economic growth. For more than a century, it has served as one of the cornerstones of American innovation, and for the most part, it works. But every system, no matter how well designed, must sometimes yield to a greater truth. That moment may be arriving.
Last week, Connecticut passed a law that would allow it to petition the U.S. Department of Health and Human Services to invoke a rarely used provision in the U.S. Patent Code, 28 U.S.C. § 1498, to produce generic versions of the blockbuster GLP-1 drugs, such as Ozempic, Wegovy, Mounjaro, and Zepbound. These medications, which have revolutionized obesity and diabetes treatment, currently carry price tags that make widespread access nearly impossible.
Connecticut’s Medicaid and CHIP program (HUSKY Health) spent $140 million on these drugs in fiscal year 2024. That number is unsustainable. Other states are facing similar crises. Some have restricted access to the drugs. Others have dropped coverage entirely. Connecticut chose a different path: expand access and challenge the price.
The state’s strategy is legally bold, but far from reckless. Section 1498 operates like a form of eminent domain for intellectual property. The government is allowed to “take” patent rights for public use, provided it compensates the patent holder with reasonable royalties, typically around 7.5 to 10 percent of production costs. It has been used before: to obtain anthrax treatments post-9/11, and to negotiate hepatitis C drug access in Louisiana.
What makes the Connecticut case different is its moral timing. GLP-1 drugs are not speculative. They work. They are not niche. They have broad application across public health. And they do not just treat a disease, they may prevent cascading health burdens like heart disease, stroke, and mobility-related disability. If these outcomes can be made available to millions, and not just to those with platinum insurance or celebrity money, then the long-term payoff to society is incalculable.
As someone who has worked in innovation, IP, and public health, I respect what patents represent. Much of the American economy is built on this scaffolding. But scaffolding is not sacred. It is meant to support construction, not block the door once the building is ready.
We have seen the costs of waiting. More than 40% of U.S. adults are obese. Nearly 1 in 10 has Type 2 diabetes. These are not individual failures. They are structural outcomes. If we have a pharmaceutical tool that can help bend the curve, especially for low-income populations who bear the highest burden, then the case for early action becomes a moral one, not just a fiscal one.
Connecticut’s proposal doesn’t erase patents. It doesn’t upend the pharmaceutical industry. It offers a royalty. It plays by the rules, just ones that haven’t been used in a while. What it challenges is the assumption that market price is always the right price, even in matters of public health. Whether Secretary Robert F. Kennedy Jr. grants the petition is another matter. Politics will enter the room. So will industry pressure. There will be lawsuits and headlines and lobbying memos dressed up as white papers. But the opportunity is real.
Sometimes public systems are at their best not when they rewrite the rules, but when they remember the ones we wrote for emergencies. This is one.
GLP-1s are not a luxury drug. They are the start of a national inflection point in how we treat obesity, diabetes, and the socioeconomic divides baked into our medical system. If we wait until the patents expire in 2031 to democratize access, we will have missed a generation of intervention. We don’t need to burn down the patent system. We need to remind it why it was built: to serve the public good.
And right now, the public is waiting.