Two semaglutide-based weight-loss and diabetes drugs are currently on the market in Estonia. One of them is Ozempic, which is injected subcutaneously in the stomach or upper arm. The other is Rybelsus, which is taken orally. Both are manufactured by the same company — Denmark's Novo Nordisk.

According to the State Agency of Medicines (RA), in 2023, semaglutide-based drugs topped Estonia's pharmaceutical market by revenue for the third year in a row. In 2024, revenue from these drugs grew by half again, topping €22 million. That accounts for 4 percent of the entire Estonian pharmaceutical market.

A pack of Ozempic costs just under €90 at the pharmacy. Janne Sepp, a specialist at RA's Drug Statistics Bureau, said nearly half of those buying the weight-loss drug pay full price for it; the rest purchase it at a discount rate.

By revenue, pembrolizumab — a drug used to treat melanoma — ranked second in the country last year at €11.5 million, while apixaban — an anticoagulant used to prevent strokes, sold under the brand name Eliquis — came in third at €8 million.

As revenue rose, so did the number of users of semaglutide-based drugs. Sepp noted that 60 percent more people used weight-loss drugs regularly last year than the year before.

Put simply: while two years ago, one in every 100 Estonian residents used weight-loss and diabetes drugs daily, by last year it was one in every 50.

Despite leading in revenue, however, weight-loss drugs are not the most commonly used in Estonia.

According to Sepp, the most widely used drugs in the country remain heart and cardiovascular medications, including those used for cholesterol and blood pressure management.

Among over-the-counter (OTC) medications, aspirin for heart health remains the most popular, followed by nasal sprays containing xylometazoline — which are sold in Estonia under brand names such as Sudafed.

"When using this, I would caution people that it can lead to dependence," Sepp warned.

The third most popular OTC drug in the country is the pain reliever ibuprofen, a non-steroidal anti-inflammatory drug (NSAID).

Number of ADHD medication users up fivefold in five years

Similarly to weight-loss drugs, the use of medications to alleviate symptoms of attention deficit hyperactivity disorder (ADHD) has also increased significantly in recent years, according to State Agency of Medicines figures.

Currently, one in every 200 people uses methylphenidate-based ADHD medications daily. According to Sepp, that number of daily users is five times higher than it was five years ago.

Methylphenidate, a prescription drug sold in Estonia under brand names including Concerta, Medikinet and Mefeda, improves users' focus and reduces impulsive behaviors and restlessness.

Sepp said that last year, the number of daily users of medications containing this active ingredient rose by about 40 percent compared to the previous year — a growth she acknowledges has indeed been very significant. According to the RA specialist, there are several factors behind this rise.

"First, the awareness that it's not just kids and teens with ADHD; it occurs in adulthood as well," she explained. "Also playing a role is the fact that the Estonian Health Insurance Fund (EHIF) reimburses treatment for patients with this diagnosis."

Alongside the growing number of prescribed ADHD medication users, Sepp noted that poisoning cases involving these drugs have also increased fivefold — from 10 in 2023 to 48 last year.

"This shows that we also need to make efforts to ensure the safe use of these medications," she said. "It's important to stress to people that they should never buy drugs from the black market. Both semaglutide and ADHD drugs are known to be trafficked illegally."

The increase in Ozempic and ADHD drug use is not unique to Estonia, however. Finnish public broadcaster Yle has also reported (link in Finnish) that semaglutide-based drugs have taken over the Finnish pharmaceutical market.

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