The new obesity drugs that are generically referred to as GLP-1s were an overnight sensation with supposed miraculous effects on weight loss. They are also very expensive, several hundred dollars a month, and have to be taken by injection forever. And although obviously not broadcast by the drug companies, they have some unpleasant and occasionally serious side effects. So not surprisingly, it turns out that a lot of people start these medications and drop them relatively quickly. In the meantime, a lot of money has been spent on them. The Blue Cross Association released data showing that 30% of patients stopped treatment within four months, before reaching their targeted dose and in most cases, before any significant weight loss occurred, and less than half stayed on for the minimum recommended period of 12 weeks. A number of factors may have played a role in why some people persist and others stop taking the drugs, but the decline was fairly consistent across all groups. While people who are obese typically have higher than average health spending, at the cost of these drugs, it isn’t clear that any money would be saved if the medications did help take weight off and keep it off. And it is just a waste of money for people to start on the medication and then stop before it can work. Expect health plans to start putting more conditions on the coverage of these drugs. (BCA Report)
Obesity Drugs Are Expensive and a Lot of People Apparently Don’t Like Their Effects
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The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.
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Hi Kevin
While I can’t disagree with any of your comments – they are, of course, accurate – I think you need to put them into perspective, given the levels of obesity and related metabolic disease in this country. For what it’s worth I’ve struggled with both for 30 years and although my overall health was still resasonablly stable, at 73 there were signs that things were begin to deteriorate. My A1C was beginning to climb, for one thing. 13 months ago, I began taking Ozempic and within 4 months, lost 25 lbs, lowered my A1C from 6.3 to 5.4, and saw my morning fasting glucose fall from 150 to 110.
I continue to take Ozempic (1 mg per week) and my weight has stabilized @170 lbs. I feel great, walk 10-15 miles per week and for the first time in 10 years, took up skiing again this winter. While suffer occasional modest side effects, the drugs has had a material impact on my health and will probably be part of my life for years to come. As a Medicare patient covered by an advantage plan, I pay a reasonable amount for the drug at this point.
My point is that if a significant number of folks can afford and tolerate Ozempic and its competitors, there is very little downside. Not everyone will be able to take advantage of these compounds but plenty will.
My concerns are 1) the total cost to the health system is extremely large, including the cost to consumers; 2) the drug companies will push these drugs to anyone they can, regardless of whether they will benefit, raising spending even further and 3) as usual, people aren’t adequately informed about the cost. There is no question that the drugs can provide benefits to people who have struggled to lose weight and I struggle with that myself, but they are being oversold.
Just an FYI, my wife had put on 25-30 unwanted pounds over the last 2-3 years. She’s a very busy trust, will estate lawyer dealing with some high end wealthy clients. She’s been working 60-70 hours a week and deferred all and any exercise. Her doctor prescribed Zepbound which she tried. At first no problems, after a few weeks she just wasn’t hungry anymore. After a month, side effects like upset stomach, GI problems and other unpleasant symptoms.
However she put up with it and lost about 20 pounds in 3 months. Now she’s taking the drug every other month hoping to ease the side effects and lose another 10-15 lbs. (As a side, she is delighted she fits back into her very nice clothing and that makes her really happy.) Of note, even though money isn’t a big issue for us, a monthly dose, 4 injections, cost a little over$1,000 per month. Her health insurance covers $0.
Point being there are certainly plus and minuses to this drug one of them being out of pocket expenses.
that sounds like a smart strategy. I am really impressed hearing from several people that it has been very helpful. I am curious for a lay person’s explanation–did she just not feel like eating?
“30% of patients stopped treatment within four months {….} and less than half stayed on for the minimum recommended period of 12 weeks.”
That doesn’t make sense.
30% in four months, another 25% by 12 months, makes over half by 12 months. Probably not best written sentence.