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Thats because generic manufacturers need to develop their version of the drug, submit it to the FDA for approval, and then scale up manufacturing

In the UK, combining Januvia (sitagliptin) and Rybelsus (semaglutide) is generally not recommended according to current clinical guidance

Motaghinejad et al., 2019)

However, it had no significant effect on mortality rate and venous blood gases

Other Label Information 16 HOW SUPPLIED/STORAGE AND HANDLING Product: 50090-5824 NDC: 50090-5824-0 .5 mL in a SYRINGE, PLASTIC / 4 in a CARTON WEGOVY (SEMAGLUTIDE) INJECTION, SOLUTION Label Images# DailyMed RxNorm Mappings# DailyMed Pharmacologic Classes# DailyMed Product Concepts# FDA-Initiated Inactive NDC Indexing# DailyMed Package Descriptions# DailyMed Dashboard NDC Coverage# DailyMed Billing Units# Products# WEGOVY NDC Codes# Ingredients# Complete SPL Sections# WARNING: RISK OF THYROID C-CELL TUMORS Boxed Warning section In rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures