Then cycle on and off it. This is common with a lot of weight loss drugs. You cycle on for social events for example, or for performance or meeting a weight class like for sports. If you're someone who responds really well, you can be 'on' for a few months to drop weight and then go 'off' and keep much of the lower weight for most of the rest of the year.
The individual tradeoffs around weight loss drugs are fascinating, and I am surprised I haven't seen simple costs raised more. Ozempic and Wegovy have list price on the order of $1000 per dose, which is a huge cost. Can the median American household making $75k afford the outlay of $12, or 24k/ year to stay thin?
I'm my experience: You have to fill out a form with the pharma mfg, and they give you a coupon to take to the pharmacy. What was $600 is now $30. It doesn't actually make any sense.
Oh also note that the very same drugs are cheaper elsewhere -- retail prices are indeed still around $1000, but in other countries and on insurance it's cheaper.
Insurance companies are in the process right now of trying to restrict coverage to anything but type 2 diabetes patients right now.
The average American household absolutely can't afford this -- but then again the cost of medical care due to comorbidities that result from obesity are pretty expensive too.
Some people are resorting to compounded versions of these drugs (which is a terrible idea, IMO) to save money as well.
I cannot believe how much this stuff costs presumably in the USA!
I just bought a box of Saxenda (liraglutide) (5 pens + 100 needles) yesterday for $492 which is like the equivalent of $300USD and I didn’t use insurance or anything to pay.
All up including the cost of getting my Dr to do the prescription it cost me $511. Which where I live this is considered expensive because most medications are free except for certain ones like saxenda.
The hardest part of accessing GLP1’s where I live is that I’m in a tiny country and the manufacturers only supplies a small amount, so waitlists for the drugs are like 5 months long.
Why is it so much more expensive in the US for these drugs? I’m struggling to understand how a place with a way more massive economy and no doubt higher demand, but also more supply, is paying these insane prices?!
> I cannot believe how much this stuff costs presumably in the USA!
> ...
> Why is it so much more expensive in the US for these drugs? I’m struggling to understand how a place with a way more massive economy and no doubt higher demand, but also more supply, is paying these insane prices?!
Yeah, this is one of the places where pricing is broken a bit.
I guess that GDP number has to come from somewhere.
> I just bought a box of Saxenda (liraglutide) (5 pens + 100 needles) yesterday for $492 which is like the equivalent of $300USD and I didn’t use insurance or anything to pay.
>
> All up including the cost of getting my Dr to do the prescription it cost me $511. Which where I live this is considered expensive because most medications are free except for certain ones like saxenda. The hardest part of accessing GLP1’s where I live is that I’m in a tiny country and the manufacturers only supplies a small amount, so waitlists for the drugs are like 5 months long.
I do wonder how long until we see more international sales of these drugs... Found a super high quality article on this from KKF[0] -- it looks like we may be making some progress on allowing more international drug importing soon.
Yes there is, you can just stop, what is this stupid clickbait title.
There is research into whether weight regain happens, and most (over 50%) of people keep some weight off after getting off the semaglutide (and tirzepatide).
Wrote about it here[0], and the the study linked is:
If you look at the STEP-1 and and SURMOUNT-4 trial extensions, the registered around a 6% drop in body weight after stopping.
Price needs to go down and availability needs to go up, but the narrative around people regaining all their weight back after stopping is silly.
Most importantly of all, people on these drugs might have a way to finally escape problems of food addiction because the effects are also psychological.
That said, there are certainly side effects, the drugs aren't magic -- they don't work for everyone and they are expensive (right now), etc. The fearmongering is annoying though.
Even from the article itself:
> A commonly cited 2022 study funded by Novo Nordisk
, the manufacturer of Wegovy and Ozempic, found that patients regained two-thirds of their lost weight a year after they stopped taking semaglutide, the main component in the medications. Wegovy is approved for obesity treatment. Ozempic is approved for Type 2 diabetes, but many people take it off-label for weight loss.
So... People kept 1/3rd of the weight they lost off for a year?! This should be lauded.
Pretty fascinating paper. I think it highlights how meaningless it is to talk about average outcomes. 18% regained all of their weight or more. 19% doubled their weight loss or more.
I would love to see the actual distributions, but It looks like a pretty standard bell curve, which isnt surprising. What is surprising is the size of the distribution! Lots of people were changing their bodies after treatment in all kinds of ways!
I would prefer diet control to Ozempic due to the potential risk of cancer, but understand that others may choose to make different tradeoffs.
> I would prefer diet control to Ozempic due to the potential risk of cancer, but understand that others may choose to make different tradeoffs.
Yeah I personally think that for many the answer is still diet/lifestyle changes and not necessarily GLP1 RAs.
It's nice that there's a new option that is at least way more effective than the previous floundering people did though. The weight loss drug landscape is littered with terrible ineffective solutions.
It would be good to compare this to diet and lifestyle change. Does it have the same or better results for less cost? Are the people that had success long term changing their diet and lifestyle and were they capable of changing it without the drug? With any drug the benefit should clearly outweigh the risk, especially if it’s expensive. If the probability is that there is no long term benefit, that should be a factor and if lifestyle change is required for success it should be encouraged.
> It would be good to compare this to diet and lifestyle change.
I agree here but this is notoriously hard to test/coordinate.
Any long term success of these drugs (or anything else) does have to come with diet and lifestyle change though, so maybe the point is moot? Measuring degrees of lifestyle change would be even harder still.
Not even thinking that lifestyle change can go the other way -- we're generally talking about improvements in eating habits or regular activity or whatever, but that stuff can also get worse! Hard to control for.
I guess the first step is to invent mind control, then once we get past those silly little rules around experimenting on humans we can finally figure out the truly optimal mix of medication and lifestyle change (this is a joke).
Ozempic is for diabetes, Wegovy is for weight management. The dosage is the difference. Not all weight management is failure of individual self-control as there are medical and genetic reasons. Also, it's not completely "free" as a magic diet pill because of the rise in thyroid neoplasms in animal models while human data doesn't replicate it, the use of it is too new to draw any conclusive conclusions.
Overall, semaglutide and metformin are leading candidates for radically improving human health for many people. If they both proof effective, they should be both made widely available and not shame or berate doctors for proscribing or patients for taking them.
The current problem is semaglutide is too damn expensive, and unfairly not covered by all insurance plans or Medicare playing favorites with medical conditions.
17 comments
[ 2.8 ms ] story [ 28.2 ms ] threadInsurance companies are in the process right now of trying to restrict coverage to anything but type 2 diabetes patients right now.
The average American household absolutely can't afford this -- but then again the cost of medical care due to comorbidities that result from obesity are pretty expensive too.
Some people are resorting to compounded versions of these drugs (which is a terrible idea, IMO) to save money as well.
I just bought a box of Saxenda (liraglutide) (5 pens + 100 needles) yesterday for $492 which is like the equivalent of $300USD and I didn’t use insurance or anything to pay.
All up including the cost of getting my Dr to do the prescription it cost me $511. Which where I live this is considered expensive because most medications are free except for certain ones like saxenda. The hardest part of accessing GLP1’s where I live is that I’m in a tiny country and the manufacturers only supplies a small amount, so waitlists for the drugs are like 5 months long.
Why is it so much more expensive in the US for these drugs? I’m struggling to understand how a place with a way more massive economy and no doubt higher demand, but also more supply, is paying these insane prices?!
> ...
> Why is it so much more expensive in the US for these drugs? I’m struggling to understand how a place with a way more massive economy and no doubt higher demand, but also more supply, is paying these insane prices?!
Yeah, this is one of the places where pricing is broken a bit.
I guess that GDP number has to come from somewhere.
> I just bought a box of Saxenda (liraglutide) (5 pens + 100 needles) yesterday for $492 which is like the equivalent of $300USD and I didn’t use insurance or anything to pay. > > All up including the cost of getting my Dr to do the prescription it cost me $511. Which where I live this is considered expensive because most medications are free except for certain ones like saxenda. The hardest part of accessing GLP1’s where I live is that I’m in a tiny country and the manufacturers only supplies a small amount, so waitlists for the drugs are like 5 months long.
I do wonder how long until we see more international sales of these drugs... Found a super high quality article on this from KKF[0] -- it looks like we may be making some progress on allowing more international drug importing soon.
[0]: https://www.kff.org/medicare/issue-brief/10-faqs-on-prescrip...
There is research into whether weight regain happens, and most (over 50%) of people keep some weight off after getting off the semaglutide (and tirzepatide).
Wrote about it here[0], and the the study linked is:
https://www.epicresearch.org/articles/many-patients-maintain...
If you look at the STEP-1 and and SURMOUNT-4 trial extensions, the registered around a 6% drop in body weight after stopping.
Price needs to go down and availability needs to go up, but the narrative around people regaining all their weight back after stopping is silly.
Most importantly of all, people on these drugs might have a way to finally escape problems of food addiction because the effects are also psychological.
That said, there are certainly side effects, the drugs aren't magic -- they don't work for everyone and they are expensive (right now), etc. The fearmongering is annoying though.
Even from the article itself:
> A commonly cited 2022 study funded by Novo Nordisk , the manufacturer of Wegovy and Ozempic, found that patients regained two-thirds of their lost weight a year after they stopped taking semaglutide, the main component in the medications. Wegovy is approved for obesity treatment. Ozempic is approved for Type 2 diabetes, but many people take it off-label for weight loss.
So... People kept 1/3rd of the weight they lost off for a year?! This should be lauded.
[0]: https://glp1.guide/content/do-people-regain-all-the-weight-l...
I would love to see the actual distributions, but It looks like a pretty standard bell curve, which isnt surprising. What is surprising is the size of the distribution! Lots of people were changing their bodies after treatment in all kinds of ways!
I would prefer diet control to Ozempic due to the potential risk of cancer, but understand that others may choose to make different tradeoffs.
Yeah I personally think that for many the answer is still diet/lifestyle changes and not necessarily GLP1 RAs.
It's nice that there's a new option that is at least way more effective than the previous floundering people did though. The weight loss drug landscape is littered with terrible ineffective solutions.
I agree here but this is notoriously hard to test/coordinate.
Any long term success of these drugs (or anything else) does have to come with diet and lifestyle change though, so maybe the point is moot? Measuring degrees of lifestyle change would be even harder still.
Not even thinking that lifestyle change can go the other way -- we're generally talking about improvements in eating habits or regular activity or whatever, but that stuff can also get worse! Hard to control for.
I guess the first step is to invent mind control, then once we get past those silly little rules around experimenting on humans we can finally figure out the truly optimal mix of medication and lifestyle change (this is a joke).
Overall, semaglutide and metformin are leading candidates for radically improving human health for many people. If they both proof effective, they should be both made widely available and not shame or berate doctors for proscribing or patients for taking them.
The current problem is semaglutide is too damn expensive, and unfairly not covered by all insurance plans or Medicare playing favorites with medical conditions.