Despite soaring prices, reported side effects (some serious), and the fact that many gain their weight back after stopping taking their weight loss medications, overweight adults are still very much interested in taking them. A recent poll from the University of Michigan found that more than 60% of overweight adults ages 50 to 80 are interested in taking one.
And many doctors are on board. “These are game-changing medications,” Shauna Levy, M.D., an obesity medicine physician at the Tulane University Medical Center and medical director of Tulane’s Bariatric and Weight Loss Center, was quoted as saying in a recent AAPR article detailing possible side effects of the new weight loss medications.
Let’s take a quick peek at last week’s headline to glimpse at what’s happening in the world of weight loss meds.
The competition heats up, and more pharma companies want in
Last week, CNBC Digital Reporter Annika Kim Constantino wrote about how the weight loss drug market is witnessing increased competition as drugmakers aim to tap into its potential worth of tens of billions in the next decade. Dominated by Novo Nordisk and Eli Lilly, the market is attracting both large and lesser-known players.
Some companies entering the race include Boehringer Ingelheim, in collaboration with Zealand Pharma, developing the drug survodutide targeting GLP-1 and glucagon, Constantino reported. The list of interested entities entering the game is growing. Consider this: Terns Pharmaceuticals is conducting early-stage trials for an oral weight-loss drug focusing on GLP-1. Viking Therapeutics and Structure Therapeutics are developing drugs targeting GLP-1 and other hormones. And Altimmune’s pemvidutide has shown promising results with a 15.6% weight loss.
Additionally, Sanofi and Bayer are considering entering the market with potential next-generation weight loss drugs. The demand is expected to rise, with Goldman Sachs projecting 15 million U.S. adults on obesity medications by 2030.
At the same time, the prices are soaring in 2024
Pharmaceutical companies have raised prices for over 700 medications, including popular drugs like Ozempic and Mounjaro, with an average increase of about 4.5% at the start of the year, slightly slower than in previous years. Notable increases include Ozempic (3.5% to $984.29) and Mounjaro (4.5% to $1,000), both GLP-1 agonists used for weight loss. CBS News reported that the analysis from 46 Brooklyn Research, a nonprofit that processes drug pricing data, found that the average price increase at year start was about 4.5%.
Why Ozempic and Mounjaro? These GLP-1 agonists, while designed to help diabetics regulate their blood sugar, also had been found to be effective weight loss drugs, prompting non-diabetics to seek out the drugs in order to slim down. Greater demand led to shortages.
Why this is bad news for employers
Increased prices mean potentially higher healthcare costs for employers. A recent article on Inc.com notes that the impact on employers may be more significant this year due to the already high costs and widespread use of Ozempic and Mounjaro. Associate Editor Brit Morse writes that market demand, coupled with inflationary pressures, is cited as the reason for the price hikes.
Morse quotes Nelly Rose, a pharmacist at NFP, a benefits consulting company, who said that covering said drugs through a workplace benefits program could be beneficial not only to employees but also to the companies who decide to offer them long-term. Employees who struggle with their weight are more likely to be on more expensive medication, or need more frequent hospital visits, Rose told Inc.com.
What Medicare won’t cover and why
If you have Medicare and want to lose weight, Ozempic won’t be covered. But if you need to take it for your type 2 diabetes, you are in luck. In an article for VeryWellHealth.com, Tanya Feke, M.D., a board-certified family physician, patient advocate and best-selling author, discussed the conditions for which Medicare covers Ozempic and when it does not.
In a nutshell, it’s super simple. Dr. Feke writes:
Medicare covers medications that it considers to be medically necessary. This includes most drugs approved by the Food and Drug Administration (FDA) for certain indications, which include a diagnosis, illness, injury, syndrome, or condition.
Ozempic is an injectable medication in the class of drugs known as glucagon-like peptide agonists (GLP-1 medications). It has an FDA-approved indication for type 2 diabetes and for cardiovascular-event reduction in people who have both type 2 diabetes (the body cannot properly regulate and use blood sugar as fuel) and known cardiovascular disease (conditions affecting the heart and blood vessels). Many Medicare Part D plans will cover Ozempic for beneficiaries who have these conditions.
Off-label use for weight loss may not be covered by Medicare due to regulations from the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, restricting coverage for cosmetic or weight loss purposes. Ozempic can be expensive, and if not covered by insurance, patients may need to go through prior authorization or step therapy processes.
Still, Dr. Feke notes, “That could change as professional organizations lobby for coverage of weight-loss medications by Medicare in the future.
Your responses and feedback are welcome!
Source: “What Are the Side Effects of New Weight Loss Medications?,” AARP.com, 1/17/24
Source: “Views on Medications for Weight Management,” HealthyAgingPoll.com, 12/13/23
Source: “The weight loss drug market may soon get more crowded. Here are the companies trying to enter the booming space,” CNBC.com
Source: “Drugmakers hiking prices for more than 700 medications, including Ozempic and Mounjaro,” CBSNews.com, undated
Source: “Prices for Weight-Loss Drugs Like Ozempic Are Skyrocketing. That’s Bad News for Employers,” Inc.com, undated
Source: “Medicare Coverage for Off-Label Ozempic to Lose Weight,” VeryWellHealth.com, 1/16/24
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