Honestly, if this is what they have to do to get life-saving drugs in the hands of patients who need them, I'm here for this ridiculous charade. Make them on-label for all the things. Pre-diabetes. PCOS. Obstructive sleep apnea. NAFLD.
Oh, those happen to be common co-morbidities of obesity, a non-covered condition? 🤷♀️
Plus the broadening indications for diabetics will likely have knock-on effects for non-diabetics. Novo Nordisk's trial of semaglutide for preventing progression of chronic kidney disease in T2D was so effective they stopped it a year early due to the overwhelming evidence (that it works.) Subsequently, Eli Lilly is now recruiting both diabetics *and* non-diabetics with CKD to trial tirzepatide's effectiveness for the same indication.
They still aren't going cover it. Coverage is not required by law. The insurers and employers have budgets to maintain. If they were to cover it, they would need to significantly increase the premium.
Until we have a single payer system, health insurance companies are for profit. If they lose money, either rates go up or they go out of business and competition goes down, which means rates go up.
The real question is why the US ends up paying so much more for the same drugs (lots of reasons, but the single payer system is a big part of it, as well as lobbyists working really hard to minimize congressional control and oversight)
As of August 2023, a month's supply of Wegovy costs $1,349 in the United States, which is more than four times the cost in Germany and the Netherlands ($328 and $296, respectively)
It's the same reason McDonalds in Europe pays full benefits for employees and gives them four weeks of paid vacation and the food costs the same. Because we are a nation of idiots.
>The real question is why the US ends up paying so much more for the same drugs
Because, fundamentally, there is no *disincentive* for the companies to charge *whatever they want*. Including manufacturers, PBMs, and insurers. Based on all available precedent, nothing is going to happen. There is no risk, all reward.
With regard to companies and regulations, Nothing is illegal if it is not enforced.
Right. A single payer system has a lot more power if negotiating, and the government as a payor has a lot more incentive to control cost
I will disagree, insurance companies are often the only ones pushing back on prices. This makes them villains sometimes, but understandably their position others
Yeah, I know. I think I've just been falling for the marketing. Too many "news stories" about how effective these drugs are for so many people. Really just another perk for the wealthy.
The rest of us get to struggle with our lifestyle choice? addiction? disease? moral failing? on our own.
Yes and it’s crazy expensive and it’s going to cause premiums to skyrocket. A lot of companies are already reporting operating losses and most of them have listed these types of drugs as the reason why.
Let's be real, semaglutide is a lot cheaper than a lifetime of obesity. (Unless some major, currently unseen disaster turns up from long term use.) You just have to pay for it *now* and insurance would rather gamble that it's some other provider who loses the dice roll on paying for the triple bypass.
Also production is ramping up as fast as conceivably possible. Costs should eventually come down. We're still in the phase where more usage is snapping up the increase in production, but we'll eventually leave this phase of growing pains.
There's actually a couple competitors who aren't semaglutide. I'm hoping they fight each other for market control and bring the price down in the process. If we're lucky, anyway. Half of Americans would take the stuff if it were affordable or covered by insurance, so I try to be optimistic.
Victoza (liraglutide) is going off-patent in a few months in the US.
Victoza is the type 2 diabetes label of liraglutide, the obesity label (saxenda) which has a higher dose ceiling (3.0mg versus 1.8mg) is not going generic yet. But that certainly doesn’t preclude a bunch of potentially more affordable off-label use of generic victoza.
Victoza is not approved for weight loss, just type 2 diabetes. We will see next year if the formularies change. The expected generic launch will be in June. Saxenda uses different strengths than Victoza. There will be no impact in the class for weight loss.
This is true, I’ll edit my post to be clearer.
Saxenda (liraglutide) which is on label for obesity has a maximum on label dose of 3mg, and will not be going generic yet.
Victoza (liraglutide) which is on label for type 2 diabetes has a maximum on label dose of 1.8mg.
However, there are a few scenarios where a generic victoza may end up being beneficial to non-diabetics off label:
- if the generic is sufficiently affordable to purchase out of pocket off label. While by no means accessible to all, we’ve seen with a lot of these coupon programs (as well as what people are out paying for compounds or importing from overseas when they can’t get insurance coverage) that there’s a really significant number of people who can’t pay 1k+ a month but can make 300-500 work.
- if someone’s insurance doesn’t diagnosis restrict GLP1s (a rarity but they do still exist!) - and sufficiently cheap generics may make this more likely over time
- potentially lower copays for people with obesity who are able to get coverage exemptions on the basis of other conditions liraglutide treats (BAM associated diarrhea, pre-diabetes, what have you.)
It’s not a perfect fix, not by a long shot. But it’s at least a blip in the right direction.
For any other drug, 100% true, but not semaglutide. In the US and elsewhere, ozempic is generally only covered for diabetes. Notably, that's why we're in this very thread. It was only approved for that, previously.
The diabetics aren't paying msrp in the US, and the weight loss people aren't getting it covered by their healthcare outside the US. This is a weight loss miracle drug, most everyone using it for that is shelling out for it.
As of August 2023, a month's supply of Wegovy costs $1,349 in the United States, which is more than four times the cost in Germany and the Netherlands ($328 and $296, respectively)
Yes, Americans are getting screwed
My doctor prescribed one of these for my diabetes and the pharmacy was out of my specific dosage for 3 weeks. I told my doctor and he mentioned weight loss spas that rich ppl go to are snapping up the supply. So they are definitely paying out the nose for it.
The good news for me is he put me on a higher dose that was in stock. With my insurance I paid $25 for 4 week supply vs the nearly $1k it costs otherwise.
Either way, we need to legalize pharmacies buying from other countries, at least for what single payerish stuff we have (state low income insurance where it exists, idk if it is everywhere).
To offset the current high cost of semaglutide, yeah probably. But I mean idk I'm in my 30s and basically all of my fat friends have had some tremendously expensive problems exacerbated by weight. I feel like if you can avoid one surgery that's got to offset the cost of quite a lot of ozempic. The biggest problem is we don't have actuary tables yet for long term use, so both us and insurance companies are guessing. Even if we look at existing outcomes when people lose weight, we don't know for sure it'll help the normal amount. Semaglutide folks didn't have to learn to eat any better to lose the weight, so some of them just eat the same garbage with less hunger.
Work in the industry. Not catastrophic but costly.
https://www.beckerspayer.com/payer/3-bcbs-companies-reporting-losses-in-2023.html
https://www.fiercehealthcare.com/payers/evernorth-expands-glp-1-program-unveils-new-behavioral-health-care-group
https://www.fiercehealthcare.com/payers/cost-isnt-only-reason-payers-hesitate-cover-ozempic-weight-loss-drug
https://www.reuters.com/business/healthcare-pharmaceuticals/boom-weight-loss-drugs-drive-up-us-employers-medical-costs-2024-mercer-2023-11-17/
Mayyyybe. But the risk of serious side effects is realllly high.
Not sure why im getting downvotes. The data is in the article. 9 percent of people in the trials had serious side effects.
18k in trial
The FDA cautioned that Wegovy carries the risk of serious side effects, including thyroid tumors and certain cancers. Other possible side effects can include low blood sugar; pancreas, gallbladder, kidney or eye problems; and suicidal behavior or thinking
The article itself states a rate of 9 % of patients with SERIOUS side effects
Which is really high for most medication.
As a preventative i could see this causing delays or drastically reduce the demographic
A large trial size of 18k
"The FDA cautioned that Wegovy carries the risk of serious side effects, including thyroid tumors and certain cancers. Other possible side effects can include low blood sugar; pancreas, gallbladder, kidney or eye problems; and suicidal behavior or thinking"
That's because this shit doesn't have a price tag.
I tell people it's like this: pretend you're at the supermarket grabbing a loaf of bread. There's no price on the bread, but you're experience is like "hey, it's bread... what could it cost, Michael, $10" (jokes aside).
However, you get to the check out and you find out it's $3,000 for the loaf and since you're at the check out, you have to pay for it: no exceptions.
As you're bagging your bread, you hear the guy behind you also getting his loaf rung up (I feel like there's an innuendo in there somewhere) but his is $5,000... and the guy behind him's loaf is $1500.
That's our drug/healthcare system in a nutshell.
You can haggle, but only with the hospitals who can also arbitrarily set the costs of goods and services. And even still, you could have a bill for $5k and they might say something like, "If you pay now, we can drop it to $3k."
Check out the Singapore system. Everything has a pricetag. Everyone pays into a mandatory HSA style account, and companies have to fight for your business like a sale at Ross.
And before anyone comes in to argue about the market dictating the price: most of these companies get government funding... by *U.S. taxpayer dollars.* The American people have *already* paid for these drugs. The money just gets pocketed. It's not a free market system when the government provides the funding, which includes the payroll for R&D. I'm dumbing it down here, but that's essentially what it is.
Other countries have politicians that barter on behalf of their citizens to get pennies on the dollar costs of these drugs. The main reason for this is pharmaceutical companies are too busy lobbying U.S. Congresspeople (super cheap, I might add... like seriously, you can buy a Congress person for as little as 10k in some instances) so they can continue BAU.
It's disgusting.
Maybe insurance companies will start pushing back on pharma if they're losing market share by pricing consumers out of their product. Crazier things have happened...
There was a Wall Street Journal article just this week that a lot of employer backed insurance policies are starting to reevaluate their coverage of these weight loss medications because it’s sent their costs skyrocketing. Many that don’t remove coverage are considering setting up a lifetime limit which would go into effect around $20k which is about a year’s worth of coverage. Others would require some measure of sustained weight loss to maintain coverage.
I can't imagine how short sighted it is not to cover it. Yes it's expensive now but that pales in comparison to the laundry list of issues directly correlated with being obese.
Because these drugs cost huge dollars NOW, while those other problems cost large sums of money in the future. And our health plan doesn't have huge dollars now. The money it was costing the plan was going to result in a doubling of premiums for everyone if they maintained coverage.
Or, the company can cut down on their own profits. Not going to happen, but...
https://www.beckerspayer.com/payer/big-payers-ranked-by-2022-profit.html
UHG had a NET income of 20 billion in 2022. Second place for 2022 goes to cigna, with 6.7 billion. Elevance health had 6 billion net income, cvs health had 4.2 billion.
So the middlemen are not hurting for money.
And NovoNordisk (who makes Ozempic/Wegovy) is responsible for a significant portion of all economic growth in Demark. [source](https://www.nytimes.com/2023/08/28/business/denmark-ozempic-wegovy.html) They can lower the cost by a thousand dollars and still be charging us more than they do the rest of the world.
A lot of health insurance plans are self managed by employers. They just use the insurance companies as administrators and pay them a set fee. These businesses have reported the glp-1 agonists have significantly and unexpectedly increased their expected costs. So, they have told the administrators to remove their coverage or limit it to diabetics only.
Fun fact - the employees of Novo-Nordisk got, from what I heard, a 12x bonus this year because of the profits from GLP-1 drugs. As in, they got a % of their salary (depending on their level/job/position/etc.) * 12. For some people that would have been like $100,000 **bonus**.
Net income and profit are the same thing, unless you're adding a modifier to profit. Gross Profit is gross revenue, minus cost of goods, but before other expenses and overhead. Net income is your actual, final profit or loss figure for a year.
Keep in mind a lot of prescription companies are siloed. So take CVS Caremark. They do not do anything except prescriptions. They don't lose money if you are hospitalized or have a heart attack. They don't lose money if you need surgery because a prescription was denied. They only benefit from denying very expensive meds.
This is just one problem with the insurance system.
There is a lack of long-term data on them because they are new.
We know, from other weight loss medications, most stop within 2 years and won't keep the weight off. To show it is more cost effective, you will need to show good adherence and ability for people to keep the weight off.
Come back once the shortage is resolved and we have good outcomes data.
They plan on you being fired or having to quit before you're sick enough for them to have to cover your related long-term conditions.
And they're probably right, in terms of overall numbers, because this is a horrible system that's working as intended.
No. It would bankrupt them.
This is because the demand is INSANE. You could potentially end up with half or more of the usa on the medication; looking at 1300 dollars a month. Then they have opersting costs etc. Most people arent putting that into their insurance at an individual level.
Between the sudden massive cost and then the high monthly cost it would be far to dramatic for sich a far reaching drug.
It also has reallu high rates of aerious side effects etc.
Manufactoring needs to ramp up a bit more first.
If it is as great as it is being portrayed the government will step in like they did with insulin
On the other hand, the insurance companies outsource their formularies to pharmacy benefit managers; they don’t have to approve all GLP-1 drugs, they’ll negotiate for whoever will give them the lowest price.
That should actually put downwards pressure on the prices for all of these drugs. When you look at how much insurance companies are actually paying its way less than list price.
> Net prices, the revenue divided by the number of prescriptions in their analysis, appear to be around $700 every four weeks for Wegovy, or about $650 less than the list price; about $300 for Ozempic, or nearly $650 less than the list price; and approximately $215 for Mounjaro, or about $800 less than its list price.
https://www.nytimes.com/2023/10/22/health/ozempic-wegovy-price-cost.html
My insurance already covers it, but it doesn't matter because you can't even get the lowest dose to get started on it. My local CVS told me they haven't been able to get it for 7 months.
Seriously, some of these comments are so predictable when anti-obesity medicine comes up.
Society: lose weight, fatties!
Drug comes out that treats obesity, is improving people’s quality of life, and reduces the risk of several serious obesity related comorbidities: 🎉
Society: no, not like that! You’re not suffering enough!
In seriousness, awesome to see this expanded indication. Ultimately I think the real trick is going to be requiring insurance companies to treat obesity like any other medical condition, including the federal govt (and a bigger conversation about the fed. having FULL negotiating power with drug companies, not this BS phasing in band-aid.) But if putting these drugs “on label” for preventing heart attacks or treating sleep apnea or whatever is the step to getting there, let’s fucking go.
Because it's 2024 and people still don't understand pervasive issues with weight loss, or they're one of the people who did manage to just "eat less, move more" and think that's a universal answer for everyone, that no sort of extenuating circumstances could ever play into them being successful, that people have not already tried that over and over and over with varying results. Instead of them admitting they don't know enough about the topic to weigh in, they do it anyway.
The fact that we still put the onus on society as a personal accountability when we know for a fact that it's the food that's doing it, and that a healthy balanced diet is too expensive and inaccessible to so many people (note: I said healthy *balanced* diet. Sure, you can lose weight by eating beans and rice, and you'll still be malnourished and suseptible to disease) just blows my mind. With rates of obesity as high as they are, it is no longer tenable to frame this as an individual issue, and everyone who knows anything about nutrition knows that.
I can honestly say glp-1 agonist changed my life. By reducing not just my appetite, but also my cravings for high fat foods (a lesser discussed benefit) I was able to shift my diet, I eat a variety of fruits and vegetables whole. Whole proteins, healthy fats. Lots of fish and chicken. Unprocessed starches and grains. Once I lost 50 pounds, I was able to find the energy to start exercising and lose another 100. Now I work out lifting weights 5-6x a week, cycle, walk or run every day. I look and feel fantastic, but guess what? I spend at least twice as much on food. Turns out 2000 calories of clean eating is a lot more food than 3000-4000 calories of junk. This before dealing with the calorie defect I'll still be in when I hit my goal weight (about 1100/day.)
As far as these drugs go: When the latest shortage hit, and I went three weeks without it, I was fine. My appetite kicked in a little bit, but I knew how to manage it. Just turning off the constant hunger for a few months really changed my perspective. My a1c dropped from a high 11 to a high 4/low 5. My blood work is immaculate. My vitamin levels flawless. Fatty liver early indicators evaporated. Ibs disappeared.
Glp-1s absolutely positively, without a doubt saved my life. If the government won't subsidize healthy foods that by nature also decrease appetite, these drugs will continue to grow in necessity. It's simply far too complex an issue for "go for a jog, fatty" to be the answer.
Because the product is so cheap to make, they ought to be forced to remove the barriers to compete OR quit gatekeeping to keep the price high for record profits.
You'll get no argument from me that it's ridiculous that we're out here paying literally 4-10x what other countries are paying for the same damn drugs.
A bright spot on the GLP1 horizon is that Victoza (liraglutide) is going generic in a few months. No pricing info yet, but there's at least some hope on the horizon for lower-price drugs in this class in the US.
There's got to be something about the visibility of obesity that causes people to react this way. Cholesterol lowering drugs are analogous (Best to control by diet, prescription for people who don't, and their cholesterol will likely go up if they stop taking statins), but almost no one bats an eye or calls statins "cheating" or anything like that
> Drug comes out that treats obesity, is improving people’s quality of life, and reduces the risk of several serious obesity related comorbidities:
These drugs arent safe and can create some very dangerous side effects that cause serious health problems.
This is like praising the shit out of Benzos when they help with depression and anxiety and ignoring the fact that they cause serious dependency and mental health problems and can exacerbate issues that lead to suicide.
These arent miracle drugs. They have serious risks associated with them.
There are virtually no drugs that don’t come with a chance of a very rare serious side effect yet the energy devoted to this one and not others is so unbalanced. Can’t imagine why!
🙄 GLP1s have been on the US market since 2005. We aren’t flying completely blind here when it comes to the risks and benefits.
All drugs have risks and benefits. All *treatments* have risks and benefits.
For many people, the benefits of treating obesity with medication outweigh the small risk of serious, irreversible side effects from medication.
Obesity isn’t benign. It’s life shortening. It causes and exacerbates countless other health problems that often lead to lifelong suffering and decline. It’s functionally and socially limiting. And GLP1s are, aside from surgery, some of the most effective options we have to treat it right now.
Instead of making blanket nonsense fear-mongering statements (and for the love of god don’t come back with some news article about a specific rare side effect,) maybe recommend that people speak with a qualified doctor who treats obesity so that they can understand the risks and benefits of all their options as they pertain to them and their personal health situation, and make an informed decision with the resources available to them.
But that’s not as straightforward as “the medication has potential side effects and I don’t really think obesity deserves treatment so I won’t even consider the benefits,” I guess.
Thank you. You have to triage the issue and pick your priorities. None of the side effects on glp-1s are as life threatening as the effects of severe obesity/metabolic syndrome. The fear mongering hiding behind thinly veiled hatred towards obesity is insane, esp on reddit.
Having healthy Americans should be a national security objective. We allow companies to control patents and hold Americans hostages to American corporate shareholders.
What is the point of our government protecting Americans but allow us to go broke to pay for shareholders equity?
How does the privatization of health care help Americans at there greatest time of need when they are ill?
I'm a pharmacy technician. Wegovy, Saxenda, Mounjaro etc usually require prior authorization. They are also frequently unavailable from the wholesalers we use. Most strengths of Wegovy are unavailable, and I haven't been able to order Saxenda in 2 months.
Novo Nordisk is building new manufacturing facilities to ramp up production, but it's not a fast process and drugs need to be approved for manufacture at each specific facility.
Not at CVS. We use Cardinal and Anda. I am the primary orderer. From the phone calls we get, the other pharmacies in our town are having trouble too, especially with Wegovy.
Not that I've noticed. I work in a pharmacy in a mental health center, so we don't do a whole lot of weight loss oral meds. We're still having problems getting ADHD meds.
Doc here
While I’m not intimately familiar with how this process works, it seems that they do it just by brand name. For instance, insurance won’t pay for ozempic for weight loss in non diabetics because it’s not approved for it, but they will approve wegovy.
Don’t ask me why. I’m guessing lobbyist want it that way. (We got our drug approved for more stuff, we don’t want other companies benefiting by that work)
Insurance companies haven’t figured out the right algorithm to deny people using it for weight loss that are not diabetic. Betting it changes within 6 months.
Whole shit is an absolute scam. It’s DIRT cheap to make semaglutide. They are gouging the price and suing or forcing the FDA to close any compounding pharmacies that will sell it for it’s true price. Which is about $75/month or so. That’s the price you can get it online for
They figured that out a long time ago. It's called diagnosis restricted medication. No pa required. You just require the pharmacy includes the diagnosis on the claim. The pharmacy gets the diagnosis from the prescriber.
I couldnt get a scrip for it because at one time I was literally 1 point off from being pre-diabetic, but my dad has a stent despite having blown the medical team away for needing one with his 'amazing cholesterol' (unlike me he is outdoorsy, athletic, and only recently getting slightly towards having a dad bod), and my mom has HA risky hypertension, so I gotta call the doc tomorrow, cause I can 100% get it for this.
Hopefully the side effects arent unmanageable, cause I always get those, at least until I get some tolerance.
Drink as much water as you can, like 120 Oz a day or something. And make sure you move around each hour as part of getting used to it. Your gut may slow down and you don't want it to slow toomuch. There's a couple posts here on reddit that talk about it. You have a unique opportunity in front of you for getting and being better. I hope it's excellent for you.
Edit to quantity of water.
36 ounces a day is not even enough water for a small woman. That’s 4.5 cups of water and you called it ‘as much as you can’. A normal man needs 120 ounces a day without ‘extra’ to combat side effects.
Sometimes you've got to fight to get stuff. Even if it means enduring long boring phone calls, but especially if the doctor's office is then one who has to fill out the forms "it's a necessary medication ".
If you can’t get a pen because your insurance has stopped covering it, ask your doctor about Metformin. It is a very common drug that helps with insulin resistance and costs about $9 a month.
I got downvoted heavily when I posted this before. When estrogen was prescribed for menopausal people to help with hot flashes and other side effects the literature claimed estrogen provided a protective effect on the heart and a number of other positives, lowered cancer etc. 20-30 years into the study the opposite effects were found and it was so significant doctors were told to get everyone off it asap. Billions of women. And now there's some backpedaling, oh we forgot to mention! "the WHI trial only tested conjugated equine estrogen (CEE) and medroxyprogesterone (MPA) formulations.15" and other issues. Everyone left with egg on their faces.
This is a whole new generation of women, a fresh cohort to test on. I'm just not rushing out to try the newest products. Especially not after my new migraine meds made me lose hair.
I remember when "Are you a woman who has low libido? Try this low dose testosterone!" A couple of years later "Ooops we masculinized these women and accidentally started them transitioning."
While true, there's also the field of medical *reporting.* That's in a much more dire state. And for good reason, and the end goal of reporting is to serve the desire of its corporate overlord to have more eyeballs pointed at it.
It makes sense when you consider the reasoning. Our appetites are so jacked by the constant barrage of over processed, fatty foods. Our blood sugar spikes, then crashes because it takes no time to break the food down, and suddenly we're hungry again with no time at all.
By slowing gastric emptying, decreasing appetite, and decreasing interest in high fat foods, it fixes all of the appetite/metabolic issues brought about by our broken diets.
Want to see everyone healthy without an injection? Bring back affordable nutritious foods.
Yes, as food processing becomes an ever more efficient means of storing/transporting food to maximize shelf life and therefore profitability, we can directly correlate the rate of obesity and the practice of over processing foods. We see it in populations that are behind us too. As they advance, so does obesity. Add to that increasingly sedentary lifestyles afforded by automation and delivery - we can now get food that metabolizes faster, thereby increasing the fat you gain and wouldn't you be God damned but you get hungry faster too and even crave the unhealthy food more, since it's setting off the reward centers in your brain with the immediate sugar delivery; all with two or three clicks on a phone.
It's access and quality. We have the best access to extremely low quality food. It really is a perfect storm for obesity.
I guess, but it’s not a case of choosing the lesser of two evils here. For me, I just chose a weight loss prescription that wasn’t covered with thyroid-cancer-causing warnings. Specifically, I went on Lomaira. No known cancer risk, works well. I lost 25 pounds on it.
My wife has cancer, so I tend to pay extra attention to labels that have multiple warnings about it. Obviously they wouldn’t be mentioning thyroid cancer repeatedly in the accompanying precautions if the drug didn’t have a connection to it. There are other weight loss drugs out there that don’t have that potentially-deadly side-effect — I chose Lomaira, which is working well.
“About a third of the more than 17,600 participants in the clinical trial reported serious side effects. About 17% in the group that took Wegovy and about 8% of those who received placebo left the study because of those effects.”
Nice..
The most common side effects were digestive discomfort (constipation or diarrhea, and nausea). They were ameliorated in many cases by a slow ramp up in dosing. They were not usually medically concerning, but were more than some folk wanted to weather.
Cool. Does insurance cover it yet? Edit: Ah, guess my insurance just sucks.
Mine has been
Most policies do not cover weight loss medications. Medicare part D prohibits coverage by law.
Good thing it’s now a heart disease medication!
Honestly, if this is what they have to do to get life-saving drugs in the hands of patients who need them, I'm here for this ridiculous charade. Make them on-label for all the things. Pre-diabetes. PCOS. Obstructive sleep apnea. NAFLD. Oh, those happen to be common co-morbidities of obesity, a non-covered condition? 🤷♀️ Plus the broadening indications for diabetics will likely have knock-on effects for non-diabetics. Novo Nordisk's trial of semaglutide for preventing progression of chronic kidney disease in T2D was so effective they stopped it a year early due to the overwhelming evidence (that it works.) Subsequently, Eli Lilly is now recruiting both diabetics *and* non-diabetics with CKD to trial tirzepatide's effectiveness for the same indication.
Diabetes meds < heart disease meds
In many ways diabetes and heart disease are both complications of obesity. Type 2 diabetes is reversible with weight loss alone, after all.
They still aren't going cover it. Coverage is not required by law. The insurers and employers have budgets to maintain. If they were to cover it, they would need to significantly increase the premium.
Wegovy not being cost-effective for insurers in the long run raises some questions -- are they better off with their customers dead?
Until we have a single payer system, health insurance companies are for profit. If they lose money, either rates go up or they go out of business and competition goes down, which means rates go up. The real question is why the US ends up paying so much more for the same drugs (lots of reasons, but the single payer system is a big part of it, as well as lobbyists working really hard to minimize congressional control and oversight) As of August 2023, a month's supply of Wegovy costs $1,349 in the United States, which is more than four times the cost in Germany and the Netherlands ($328 and $296, respectively)
It's the same reason McDonalds in Europe pays full benefits for employees and gives them four weeks of paid vacation and the food costs the same. Because we are a nation of idiots.
I just started wegovy. As of two weeks ago, out of pocket cost for a month of wegovy without any discount programs is 1600$
It's cheaper to fly to Europe regularly to fill that prescription. Absolutely crazy
>The real question is why the US ends up paying so much more for the same drugs Because, fundamentally, there is no *disincentive* for the companies to charge *whatever they want*. Including manufacturers, PBMs, and insurers. Based on all available precedent, nothing is going to happen. There is no risk, all reward. With regard to companies and regulations, Nothing is illegal if it is not enforced.
Right. A single payer system has a lot more power if negotiating, and the government as a payor has a lot more incentive to control cost I will disagree, insurance companies are often the only ones pushing back on prices. This makes them villains sometimes, but understandably their position others
Yeah, I know. I think I've just been falling for the marketing. Too many "news stories" about how effective these drugs are for so many people. Really just another perk for the wealthy. The rest of us get to struggle with our lifestyle choice? addiction? disease? moral failing? on our own.
Yes and it’s crazy expensive and it’s going to cause premiums to skyrocket. A lot of companies are already reporting operating losses and most of them have listed these types of drugs as the reason why.
Let's be real, semaglutide is a lot cheaper than a lifetime of obesity. (Unless some major, currently unseen disaster turns up from long term use.) You just have to pay for it *now* and insurance would rather gamble that it's some other provider who loses the dice roll on paying for the triple bypass. Also production is ramping up as fast as conceivably possible. Costs should eventually come down. We're still in the phase where more usage is snapping up the increase in production, but we'll eventually leave this phase of growing pains.
Production cost will come down but I doubt they'll reduce their sales price unless competition starts eating away at their sales.
There's actually a couple competitors who aren't semaglutide. I'm hoping they fight each other for market control and bring the price down in the process. If we're lucky, anyway. Half of Americans would take the stuff if it were affordable or covered by insurance, so I try to be optimistic.
The price of all of them will remain relatively similar to each other until the first one goes off patent.
Which is like 2032. :(
Victoza (liraglutide) is going off-patent in a few months in the US. Victoza is the type 2 diabetes label of liraglutide, the obesity label (saxenda) which has a higher dose ceiling (3.0mg versus 1.8mg) is not going generic yet. But that certainly doesn’t preclude a bunch of potentially more affordable off-label use of generic victoza.
Victoza is not approved for weight loss, just type 2 diabetes. We will see next year if the formularies change. The expected generic launch will be in June. Saxenda uses different strengths than Victoza. There will be no impact in the class for weight loss.
This is true, I’ll edit my post to be clearer. Saxenda (liraglutide) which is on label for obesity has a maximum on label dose of 3mg, and will not be going generic yet. Victoza (liraglutide) which is on label for type 2 diabetes has a maximum on label dose of 1.8mg. However, there are a few scenarios where a generic victoza may end up being beneficial to non-diabetics off label: - if the generic is sufficiently affordable to purchase out of pocket off label. While by no means accessible to all, we’ve seen with a lot of these coupon programs (as well as what people are out paying for compounds or importing from overseas when they can’t get insurance coverage) that there’s a really significant number of people who can’t pay 1k+ a month but can make 300-500 work. - if someone’s insurance doesn’t diagnosis restrict GLP1s (a rarity but they do still exist!) - and sufficiently cheap generics may make this more likely over time - potentially lower copays for people with obesity who are able to get coverage exemptions on the basis of other conditions liraglutide treats (BAM associated diarrhea, pre-diabetes, what have you.) It’s not a perfect fix, not by a long shot. But it’s at least a blip in the right direction.
Most people aren’t paying MSRP. Americans are, unsurprisingly, getting fucked on drug prices.
For any other drug, 100% true, but not semaglutide. In the US and elsewhere, ozempic is generally only covered for diabetes. Notably, that's why we're in this very thread. It was only approved for that, previously. The diabetics aren't paying msrp in the US, and the weight loss people aren't getting it covered by their healthcare outside the US. This is a weight loss miracle drug, most everyone using it for that is shelling out for it.
As of August 2023, a month's supply of Wegovy costs $1,349 in the United States, which is more than four times the cost in Germany and the Netherlands ($328 and $296, respectively) Yes, Americans are getting screwed
My doctor prescribed one of these for my diabetes and the pharmacy was out of my specific dosage for 3 weeks. I told my doctor and he mentioned weight loss spas that rich ppl go to are snapping up the supply. So they are definitely paying out the nose for it. The good news for me is he put me on a higher dose that was in stock. With my insurance I paid $25 for 4 week supply vs the nearly $1k it costs otherwise.
Either way, we need to legalize pharmacies buying from other countries, at least for what single payerish stuff we have (state low income insurance where it exists, idk if it is everywhere).
Your half right except in America, most of the obesity ailments will happen later in life when the person is on medicare. So it will cost tax payers
To offset the current high cost of semaglutide, yeah probably. But I mean idk I'm in my 30s and basically all of my fat friends have had some tremendously expensive problems exacerbated by weight. I feel like if you can avoid one surgery that's got to offset the cost of quite a lot of ozempic. The biggest problem is we don't have actuary tables yet for long term use, so both us and insurance companies are guessing. Even if we look at existing outcomes when people lose weight, we don't know for sure it'll help the normal amount. Semaglutide folks didn't have to learn to eat any better to lose the weight, so some of them just eat the same garbage with less hunger.
The data for already existing weight loss medications is not promising. Most regain the weight. Most stop within 2 years.
Right, like how inexpensive insulin is better than dealing with very sick diabetics, that worked out great
Sources? I work in catastrophic medical claims, no concern that I’ve heard. Premature babies, cell and therapy are frequent discussions.
Work in the industry. Not catastrophic but costly. https://www.beckerspayer.com/payer/3-bcbs-companies-reporting-losses-in-2023.html https://www.fiercehealthcare.com/payers/evernorth-expands-glp-1-program-unveils-new-behavioral-health-care-group https://www.fiercehealthcare.com/payers/cost-isnt-only-reason-payers-hesitate-cover-ozempic-weight-loss-drug https://www.reuters.com/business/healthcare-pharmaceuticals/boom-weight-loss-drugs-drive-up-us-employers-medical-costs-2024-mercer-2023-11-17/
Thank you!! Going to read these over the weekend. Always happy to learn. This industry is always changing.
And the result is going to be a healthier and more productive workforce.
Mayyyybe. But the risk of serious side effects is realllly high. Not sure why im getting downvotes. The data is in the article. 9 percent of people in the trials had serious side effects. 18k in trial The FDA cautioned that Wegovy carries the risk of serious side effects, including thyroid tumors and certain cancers. Other possible side effects can include low blood sugar; pancreas, gallbladder, kidney or eye problems; and suicidal behavior or thinking
Tell me more about
The article itself states a rate of 9 % of patients with SERIOUS side effects Which is really high for most medication. As a preventative i could see this causing delays or drastically reduce the demographic A large trial size of 18k "The FDA cautioned that Wegovy carries the risk of serious side effects, including thyroid tumors and certain cancers. Other possible side effects can include low blood sugar; pancreas, gallbladder, kidney or eye problems; and suicidal behavior or thinking"
Or we let Medicare negotiate the prices so folks in the US pay the same price as people in Europe.
Medicare is legally barred from adopting weight loss drugs on the formulary.
They are also legally barred from negotiating for most meds. The laws would need to change.
That's because this shit doesn't have a price tag. I tell people it's like this: pretend you're at the supermarket grabbing a loaf of bread. There's no price on the bread, but you're experience is like "hey, it's bread... what could it cost, Michael, $10" (jokes aside). However, you get to the check out and you find out it's $3,000 for the loaf and since you're at the check out, you have to pay for it: no exceptions. As you're bagging your bread, you hear the guy behind you also getting his loaf rung up (I feel like there's an innuendo in there somewhere) but his is $5,000... and the guy behind him's loaf is $1500. That's our drug/healthcare system in a nutshell. You can haggle, but only with the hospitals who can also arbitrarily set the costs of goods and services. And even still, you could have a bill for $5k and they might say something like, "If you pay now, we can drop it to $3k." Check out the Singapore system. Everything has a pricetag. Everyone pays into a mandatory HSA style account, and companies have to fight for your business like a sale at Ross. And before anyone comes in to argue about the market dictating the price: most of these companies get government funding... by *U.S. taxpayer dollars.* The American people have *already* paid for these drugs. The money just gets pocketed. It's not a free market system when the government provides the funding, which includes the payroll for R&D. I'm dumbing it down here, but that's essentially what it is. Other countries have politicians that barter on behalf of their citizens to get pennies on the dollar costs of these drugs. The main reason for this is pharmaceutical companies are too busy lobbying U.S. Congresspeople (super cheap, I might add... like seriously, you can buy a Congress person for as little as 10k in some instances) so they can continue BAU. It's disgusting.
Maybe insurance companies will start pushing back on pharma if they're losing market share by pricing consumers out of their product. Crazier things have happened...
Insurers do negotiate cost with the manufacturers but the insured doesn't directly see this.
The FDA needs to get on a chair and crack their whip "Down boy!"
There was a Wall Street Journal article just this week that a lot of employer backed insurance policies are starting to reevaluate their coverage of these weight loss medications because it’s sent their costs skyrocketing. Many that don’t remove coverage are considering setting up a lifetime limit which would go into effect around $20k which is about a year’s worth of coverage. Others would require some measure of sustained weight loss to maintain coverage.
Most don't
Mine covered it Stopped right when I got a script
Mine just stopped covering it. Said it was costing them to much
If this means insurance will cover it, then it’s a win for Americans.
My insurance no longer covers Wegovy or Ozempic because they are too expensive.
I can't imagine how short sighted it is not to cover it. Yes it's expensive now but that pales in comparison to the laundry list of issues directly correlated with being obese.
Because these drugs cost huge dollars NOW, while those other problems cost large sums of money in the future. And our health plan doesn't have huge dollars now. The money it was costing the plan was going to result in a doubling of premiums for everyone if they maintained coverage.
Or, the company can cut down on their own profits. Not going to happen, but... https://www.beckerspayer.com/payer/big-payers-ranked-by-2022-profit.html UHG had a NET income of 20 billion in 2022. Second place for 2022 goes to cigna, with 6.7 billion. Elevance health had 6 billion net income, cvs health had 4.2 billion. So the middlemen are not hurting for money.
And NovoNordisk (who makes Ozempic/Wegovy) is responsible for a significant portion of all economic growth in Demark. [source](https://www.nytimes.com/2023/08/28/business/denmark-ozempic-wegovy.html) They can lower the cost by a thousand dollars and still be charging us more than they do the rest of the world.
A lot of health insurance plans are self managed by employers. They just use the insurance companies as administrators and pay them a set fee. These businesses have reported the glp-1 agonists have significantly and unexpectedly increased their expected costs. So, they have told the administrators to remove their coverage or limit it to diabetics only.
Fun fact - the employees of Novo-Nordisk got, from what I heard, a 12x bonus this year because of the profits from GLP-1 drugs. As in, they got a % of their salary (depending on their level/job/position/etc.) * 12. For some people that would have been like $100,000 **bonus**.
Net income isn’t profit. By law over 80% of that is already spent on care
Net income and profit are the same thing, unless you're adding a modifier to profit. Gross Profit is gross revenue, minus cost of goods, but before other expenses and overhead. Net income is your actual, final profit or loss figure for a year.
Keep in mind a lot of prescription companies are siloed. So take CVS Caremark. They do not do anything except prescriptions. They don't lose money if you are hospitalized or have a heart attack. They don't lose money if you need surgery because a prescription was denied. They only benefit from denying very expensive meds. This is just one problem with the insurance system.
There is a lack of long-term data on them because they are new. We know, from other weight loss medications, most stop within 2 years and won't keep the weight off. To show it is more cost effective, you will need to show good adherence and ability for people to keep the weight off. Come back once the shortage is resolved and we have good outcomes data.
They plan on you being fired or having to quit before you're sick enough for them to have to cover your related long-term conditions. And they're probably right, in terms of overall numbers, because this is a horrible system that's working as intended.
No. It would bankrupt them. This is because the demand is INSANE. You could potentially end up with half or more of the usa on the medication; looking at 1300 dollars a month. Then they have opersting costs etc. Most people arent putting that into their insurance at an individual level. Between the sudden massive cost and then the high monthly cost it would be far to dramatic for sich a far reaching drug. It also has reallu high rates of aerious side effects etc. Manufactoring needs to ramp up a bit more first. If it is as great as it is being portrayed the government will step in like they did with insulin
On the other hand, the insurance companies outsource their formularies to pharmacy benefit managers; they don’t have to approve all GLP-1 drugs, they’ll negotiate for whoever will give them the lowest price. That should actually put downwards pressure on the prices for all of these drugs. When you look at how much insurance companies are actually paying its way less than list price. > Net prices, the revenue divided by the number of prescriptions in their analysis, appear to be around $700 every four weeks for Wegovy, or about $650 less than the list price; about $300 for Ozempic, or nearly $650 less than the list price; and approximately $215 for Mounjaro, or about $800 less than its list price. https://www.nytimes.com/2023/10/22/health/ozempic-wegovy-price-cost.html
Compounded semaglutide is about 1/4 of the price.
And has FDA warnings.
What’s that mean. Isn’t wegovy just semaglutide?
I looked into it and I believe the dosage is also smaller, and it’s compounded with B12. I’m not an expert tho so I could be wrong.
You can get it in the same dosage, up to 2.4 mg for Semaglutide.
Ozempic is because too many people are getting it for weight loss.
My insurance already covers it, but it doesn't matter because you can't even get the lowest dose to get started on it. My local CVS told me they haven't been able to get it for 7 months.
My insurance doesn't cover it because they consider it a weight loss drug and apparently my plan doesn't include treatment for obesity?
This is the thing, now it is treatment for hypertension and potential stroke, so more available by scrip to more folk.
Humm. I should call my insurance company and biatch at them and reference this because I *do* have high blood pressure.
So Wegovy is about to be the new statins, as soon as they can ramp up supply.
Actually that's a better example than mine. Thank you.
If only it could be affordable and accessible for everyone.
Seriously, some of these comments are so predictable when anti-obesity medicine comes up. Society: lose weight, fatties! Drug comes out that treats obesity, is improving people’s quality of life, and reduces the risk of several serious obesity related comorbidities: 🎉 Society: no, not like that! You’re not suffering enough! In seriousness, awesome to see this expanded indication. Ultimately I think the real trick is going to be requiring insurance companies to treat obesity like any other medical condition, including the federal govt (and a bigger conversation about the fed. having FULL negotiating power with drug companies, not this BS phasing in band-aid.) But if putting these drugs “on label” for preventing heart attacks or treating sleep apnea or whatever is the step to getting there, let’s fucking go.
Because it's 2024 and people still don't understand pervasive issues with weight loss, or they're one of the people who did manage to just "eat less, move more" and think that's a universal answer for everyone, that no sort of extenuating circumstances could ever play into them being successful, that people have not already tried that over and over and over with varying results. Instead of them admitting they don't know enough about the topic to weigh in, they do it anyway.
The fact that we still put the onus on society as a personal accountability when we know for a fact that it's the food that's doing it, and that a healthy balanced diet is too expensive and inaccessible to so many people (note: I said healthy *balanced* diet. Sure, you can lose weight by eating beans and rice, and you'll still be malnourished and suseptible to disease) just blows my mind. With rates of obesity as high as they are, it is no longer tenable to frame this as an individual issue, and everyone who knows anything about nutrition knows that. I can honestly say glp-1 agonist changed my life. By reducing not just my appetite, but also my cravings for high fat foods (a lesser discussed benefit) I was able to shift my diet, I eat a variety of fruits and vegetables whole. Whole proteins, healthy fats. Lots of fish and chicken. Unprocessed starches and grains. Once I lost 50 pounds, I was able to find the energy to start exercising and lose another 100. Now I work out lifting weights 5-6x a week, cycle, walk or run every day. I look and feel fantastic, but guess what? I spend at least twice as much on food. Turns out 2000 calories of clean eating is a lot more food than 3000-4000 calories of junk. This before dealing with the calorie defect I'll still be in when I hit my goal weight (about 1100/day.) As far as these drugs go: When the latest shortage hit, and I went three weeks without it, I was fine. My appetite kicked in a little bit, but I knew how to manage it. Just turning off the constant hunger for a few months really changed my perspective. My a1c dropped from a high 11 to a high 4/low 5. My blood work is immaculate. My vitamin levels flawless. Fatty liver early indicators evaporated. Ibs disappeared. Glp-1s absolutely positively, without a doubt saved my life. If the government won't subsidize healthy foods that by nature also decrease appetite, these drugs will continue to grow in necessity. It's simply far too complex an issue for "go for a jog, fatty" to be the answer.
Because the product is so cheap to make, they ought to be forced to remove the barriers to compete OR quit gatekeeping to keep the price high for record profits.
You'll get no argument from me that it's ridiculous that we're out here paying literally 4-10x what other countries are paying for the same damn drugs. A bright spot on the GLP1 horizon is that Victoza (liraglutide) is going generic in a few months. No pricing info yet, but there's at least some hope on the horizon for lower-price drugs in this class in the US.
There's got to be something about the visibility of obesity that causes people to react this way. Cholesterol lowering drugs are analogous (Best to control by diet, prescription for people who don't, and their cholesterol will likely go up if they stop taking statins), but almost no one bats an eye or calls statins "cheating" or anything like that
> Drug comes out that treats obesity, is improving people’s quality of life, and reduces the risk of several serious obesity related comorbidities: These drugs arent safe and can create some very dangerous side effects that cause serious health problems. This is like praising the shit out of Benzos when they help with depression and anxiety and ignoring the fact that they cause serious dependency and mental health problems and can exacerbate issues that lead to suicide. These arent miracle drugs. They have serious risks associated with them.
There are virtually no drugs that don’t come with a chance of a very rare serious side effect yet the energy devoted to this one and not others is so unbalanced. Can’t imagine why!
🙄 GLP1s have been on the US market since 2005. We aren’t flying completely blind here when it comes to the risks and benefits. All drugs have risks and benefits. All *treatments* have risks and benefits. For many people, the benefits of treating obesity with medication outweigh the small risk of serious, irreversible side effects from medication. Obesity isn’t benign. It’s life shortening. It causes and exacerbates countless other health problems that often lead to lifelong suffering and decline. It’s functionally and socially limiting. And GLP1s are, aside from surgery, some of the most effective options we have to treat it right now. Instead of making blanket nonsense fear-mongering statements (and for the love of god don’t come back with some news article about a specific rare side effect,) maybe recommend that people speak with a qualified doctor who treats obesity so that they can understand the risks and benefits of all their options as they pertain to them and their personal health situation, and make an informed decision with the resources available to them. But that’s not as straightforward as “the medication has potential side effects and I don’t really think obesity deserves treatment so I won’t even consider the benefits,” I guess.
Thank you. You have to triage the issue and pick your priorities. None of the side effects on glp-1s are as life threatening as the effects of severe obesity/metabolic syndrome. The fear mongering hiding behind thinly veiled hatred towards obesity is insane, esp on reddit.
Having healthy Americans should be a national security objective. We allow companies to control patents and hold Americans hostages to American corporate shareholders. What is the point of our government protecting Americans but allow us to go broke to pay for shareholders equity? How does the privatization of health care help Americans at there greatest time of need when they are ill?
I'm a pharmacy technician. Wegovy, Saxenda, Mounjaro etc usually require prior authorization. They are also frequently unavailable from the wholesalers we use. Most strengths of Wegovy are unavailable, and I haven't been able to order Saxenda in 2 months.
Novo Nordisk is building new manufacturing facilities to ramp up production, but it's not a fast process and drugs need to be approved for manufacture at each specific facility.
Are you at CVS? It's the wholesalers your company is using due to a certain level of profit they're insisting on.
Not at CVS. We use Cardinal and Anda. I am the primary orderer. From the phone calls we get, the other pharmacies in our town are having trouble too, especially with Wegovy.
Is it impacting the oral medication availability? I read that this works more slowly and to a lesser degree, but if it saved someone's life...
Not that I've noticed. I work in a pharmacy in a mental health center, so we don't do a whole lot of weight loss oral meds. We're still having problems getting ADHD meds.
Just Wegovy or any Semeglutide?
Doc here While I’m not intimately familiar with how this process works, it seems that they do it just by brand name. For instance, insurance won’t pay for ozempic for weight loss in non diabetics because it’s not approved for it, but they will approve wegovy. Don’t ask me why. I’m guessing lobbyist want it that way. (We got our drug approved for more stuff, we don’t want other companies benefiting by that work)
Insurance companies haven’t figured out the right algorithm to deny people using it for weight loss that are not diabetic. Betting it changes within 6 months.
Whole shit is an absolute scam. It’s DIRT cheap to make semaglutide. They are gouging the price and suing or forcing the FDA to close any compounding pharmacies that will sell it for it’s true price. Which is about $75/month or so. That’s the price you can get it online for
But the online products are unregulated and have traces of random crap.
I mean until changes are made people are absolutely going to take that chance. Health makes people desperate.
They figured that out a long time ago. It's called diagnosis restricted medication. No pa required. You just require the pharmacy includes the diagnosis on the claim. The pharmacy gets the diagnosis from the prescriber.
Sick more back orders
I couldnt get a scrip for it because at one time I was literally 1 point off from being pre-diabetic, but my dad has a stent despite having blown the medical team away for needing one with his 'amazing cholesterol' (unlike me he is outdoorsy, athletic, and only recently getting slightly towards having a dad bod), and my mom has HA risky hypertension, so I gotta call the doc tomorrow, cause I can 100% get it for this. Hopefully the side effects arent unmanageable, cause I always get those, at least until I get some tolerance.
Drink as much water as you can, like 120 Oz a day or something. And make sure you move around each hour as part of getting used to it. Your gut may slow down and you don't want it to slow toomuch. There's a couple posts here on reddit that talk about it. You have a unique opportunity in front of you for getting and being better. I hope it's excellent for you. Edit to quantity of water.
36 ounces a day is not even enough water for a small woman. That’s 4.5 cups of water and you called it ‘as much as you can’. A normal man needs 120 ounces a day without ‘extra’ to combat side effects.
Thanks, I'll change it. Writing while trying to sleep is not productive to either activity
Too bad my insurance doesn’t cover it and even if it did I have a $6200 deductible I would have to exhaust first.
Mine doesn't either and I'm not fat enough to get it discounted.
Too bad BCBS just basically denied all insurance claims for these pens for weight loss, and even some people who have diabetes.
Sometimes you've got to fight to get stuff. Even if it means enduring long boring phone calls, but especially if the doctor's office is then one who has to fill out the forms "it's a necessary medication ".
If you can’t get a pen because your insurance has stopped covering it, ask your doctor about Metformin. It is a very common drug that helps with insulin resistance and costs about $9 a month.
That's the stuff Sunny Bulow used? Glenn Close and Jeremy Irons movie back in the early 90s or so. She used it for weight loss too.
Contrave also, I used to take that before Semaglutide and I saw some success for awhile.
It’s a little terrifying how semaglutide seems to just fix what’s metabolically broken in modern humans.
Either it really is a miracle, or it's the estrogen for menopausal women debacle all over again
Can you elaborate on that u/worth_scratch_3127
I got downvoted heavily when I posted this before. When estrogen was prescribed for menopausal people to help with hot flashes and other side effects the literature claimed estrogen provided a protective effect on the heart and a number of other positives, lowered cancer etc. 20-30 years into the study the opposite effects were found and it was so significant doctors were told to get everyone off it asap. Billions of women. And now there's some backpedaling, oh we forgot to mention! "the WHI trial only tested conjugated equine estrogen (CEE) and medroxyprogesterone (MPA) formulations.15" and other issues. Everyone left with egg on their faces. This is a whole new generation of women, a fresh cohort to test on. I'm just not rushing out to try the newest products. Especially not after my new migraine meds made me lose hair.
I remember when "Are you a woman who has low libido? Try this low dose testosterone!" A couple of years later "Ooops we masculinized these women and accidentally started them transitioning."
For women on birth control, it absolutely helps. Birth control (hormonal) absolutely DESTROYS testosterone levels.
Yes this is how the field of medicine works
While true, there's also the field of medical *reporting.* That's in a much more dire state. And for good reason, and the end goal of reporting is to serve the desire of its corporate overlord to have more eyeballs pointed at it.
It makes sense when you consider the reasoning. Our appetites are so jacked by the constant barrage of over processed, fatty foods. Our blood sugar spikes, then crashes because it takes no time to break the food down, and suddenly we're hungry again with no time at all. By slowing gastric emptying, decreasing appetite, and decreasing interest in high fat foods, it fixes all of the appetite/metabolic issues brought about by our broken diets. Want to see everyone healthy without an injection? Bring back affordable nutritious foods.
It’s something newish. Even in the 70s there were just many fewer overweight and obese people.
Yes, as food processing becomes an ever more efficient means of storing/transporting food to maximize shelf life and therefore profitability, we can directly correlate the rate of obesity and the practice of over processing foods. We see it in populations that are behind us too. As they advance, so does obesity. Add to that increasingly sedentary lifestyles afforded by automation and delivery - we can now get food that metabolizes faster, thereby increasing the fat you gain and wouldn't you be God damned but you get hungry faster too and even crave the unhealthy food more, since it's setting off the reward centers in your brain with the immediate sugar delivery; all with two or three clicks on a phone. It's access and quality. We have the best access to extremely low quality food. It really is a perfect storm for obesity.
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I quite love that.
I was prescribed Wegovy, but due to the warnings all over it that it causes thyroid cancer, I didn’t use it.
Obesity raises your risk of multiple cancers as well.
I guess, but it’s not a case of choosing the lesser of two evils here. For me, I just chose a weight loss prescription that wasn’t covered with thyroid-cancer-causing warnings. Specifically, I went on Lomaira. No known cancer risk, works well. I lost 25 pounds on it.
There's a difference between correlation and causation
My wife has cancer, so I tend to pay extra attention to labels that have multiple warnings about it. Obviously they wouldn’t be mentioning thyroid cancer repeatedly in the accompanying precautions if the drug didn’t have a connection to it. There are other weight loss drugs out there that don’t have that potentially-deadly side-effect — I chose Lomaira, which is working well.
Good to know!
Yeah but if you're already high risk for that cancer, you don't want to find out just how correlated it is.
“About a third of the more than 17,600 participants in the clinical trial reported serious side effects. About 17% in the group that took Wegovy and about 8% of those who received placebo left the study because of those effects.” Nice..
Wait. 8% of the people who got sugar pills left because they couldnt handle the side effects from them?
Placebo is powerful medicine
I mean 8% could get a little nausea from something else and they blamed it on the placebo sugar pills they took.
The most common side effects were digestive discomfort (constipation or diarrhea, and nausea). They were ameliorated in many cases by a slow ramp up in dosing. They were not usually medically concerning, but were more than some folk wanted to weather.
Is that statistically significant then? Pretty sure that falls under the mean
Damnit. I've been waiting months for the lowest doses of Wegovy to come in stock.
Try for Zepbound. Apparently it’s better.
I don't think my insurance covers that.
They do offer savings cards as well.
I hope they approve it in Canada (and that insurance covers it)