In 2023, potent weight loss drugs like Wegovy from Novo Nordisk entered the public eye, gaining attention from social media, doctor’s offices, and cocktail parties, offering a new way to combat the record-setting obesity rates.
However, the extraordinary demand and high prices for these medications will likely make them unaffordable for many patients who could benefit from them in the coming year.
These new drugs, known as GLP-1 agonists, mimic the activity of a hormone that slows down digestion and helps people feel full for longer. In clinical studies, people lost 15 to 20% of their body weight depending on the medication. Nearly 120 million American adults could be eligible for treatment, while Novo reportedly sees over 760 million people globally with obesity as its target market.
Researchers have also found that these treatments can protect against heart and kidney disease, and are currently testing them for conditions such as Parkinson’s and alcohol dependency.
However, Novo Nordisk cannot manufacture enough Wegovy to meet demand and is only selling it in some of the wealthiest countries in the world. Many people are turning to Novo’s diabetes medication, Ozempic, which contains the same active ingredient, to lose weight. This has led to a shortage of Ozempic and new insurance hurdles for diabetes patients who need it.
Eli Lilly and Co. have just released Zepbound, another GLP-1 for weight loss. Competitors in the pharmaceutical industry, including Pfizer Inc and AstraZeneca Plc, also plan to enter the market, which is expected to reach a volume of $100 billion within a decade. They are testing versions that may be more convenient and have fewer side effects.
WHY IT MATTERS
If drugs like Wegovy prove effective, they can change the lives of people whose weight increases their health risks, from diabetes to heart and kidney disease. Many patients have struggled with obesity for years and have found that changing their diet and exercise alone is not sustainable.
However, the potential costs are exceptional, with US prices for Wegovy and Zepbound exceeding $1,000 per month. Current data suggests that patients may need to use them long-term to maintain their weight loss.
Private health insurers are finding ways to delay or deny the use of these medications. Some doctors report that it is more difficult for them to obtain health insurance for Black and Hispanic patients with obesity who rely on state health insurance and are at higher risk for diabetes and other complications.
„What will it mean for the majority of us? Will it only be accessible to the elite who can afford it out of pocket?“ said Dr. Andres Acosta, an obesity expert at the Mayo Clinic.
Regulators are reviewing reports of rare side effects, including a possible link to suicidal thoughts, while determining any long-term risks will take years.
WHAT IT MEANS FOR 2024
These trends raise profound questions for doctors who want to identify which of their patients need the medications the most and how to provide them with access.
Dr. Lauren Eberly, Assistant Professor of Cardiovascular Medicine at the Perelman School of Medicine, University of Pennsylvania, noted that the use of GLP-1 medications for diabetes in Black, Asian, and Hispanic patients with private health insurance was lower than in their white counterparts. She is working on a new study on coverage trends for weight loss.
„We are very concerned about the inequities that will be perpetuated as a direct result of the inaccessibility of these medications, particularly for more marginalized groups,“ said Eberly.
Dr. Lauren Oshman, Associate Professor at the Department of Family Medicine, University of Michigan, expects that many patients in 2024 will no longer be able to afford the new weight loss medications. Doctors should understand all tools for treating obesity, from counseling to older, cheaper medications that may lead to a lower percentage of weight loss but still offer health benefits, Oshman said.
„In some ways, we can do a better job overall in treating obesity,“ she said.
Obesity experts also say they need to consider who does not need the medications. Some estimates suggest that up to 40% of people with obesity may have no other serious health risks.
„These medications should not be given or taken by people who really do not need them,“ said Dr. Susan Yanovski, Co-Director of Obesity Research at the National Institute of Diabetes and Digestive and Kidney Diseases. For those who do, research must be conducted on how they can maintain weight loss long-term and whether they can reduce or discontinue the use of the medications.
„We not only want to influence their weight,“ Yanovski said. „Our ultimate goal is to influence how they feel and possibly how long they live.“
(Reporting by Michele Gershberg; editing by Rosalba O’Brien)