11 ms·

Mounjaro is not an obesity drug. It's a type 2 diabetes drug. Do not call it an obesity drug. The headline is editorialized. The linked article's headline: The

• HDThoreaun 4y ago
  People aren’t stupid. Mounjaro is the most effective weight loss drug in existence. Better than wegovy and the other brand name semaglutides. If you think FDA approval is going to stop people from wanting and getting it you’re sorely mistaken.
  • bedast 4y ago
    Yeah, feel free to spend the $1200/mo for it then. Because that's off-label use when there are drugs in this class with on-label weight loss use. And sometime this year, tirzepatide is expected to be among them. The coupon was changed because people were abusing it. This drug is approved for diabetes, not weight loss.
    • __Parfait__ 4y ago
      Don't worry, it will be approved for the latter soon enough, perhaps under a different brand. No way to put this genie back in the bottle, sorry.
      • bedast 4y ago
        Yes, this is what Novo Nordisk did with Victoza around 2014 with the release of Saxenda. And then again with Ozempic around 2021 with Wegovy. These weight loss versions exist. And there will be one likely this year based on tirzepatide from Lilly (I haven't looked up if they have a name for it yet).
        • finneganscat 4y ago
          [dead]
    • counttheforks 4y ago
      Why are you defending the price gouging of the american healthcare system? Do you really only care about yourself?
      • bedast 4y ago
        I care that many people I know are losing glycemic control because they're going on a waiting list for their medication while Kim K and Elon Musk and TikTok promote easy mode cosmetic weight loss.
        • serf 4y ago
          if someone is 'losing glycemic control' because they can't get a specific new en-vogue med, then their doctor is doing a poor job. there is a very big problem with blaming the suffering who find relief with this drug -- regardless of what their ailment is -- rather than blaming the systems and processes that lead to a supposed shortage that urged a price adjustment. forgive me for diving into conspiracy for a second here.. do you really think for a second that the pharmaceutical groups responsible for this class of drug do not have the facilities to ramp up production? They absolutely do -- the problem here is that since it's a gold-mine there is even more cash capture to occur with an added scarcity element, hence the price adjustment. The price adjustment wasn't to champion the diabetics over the obese, it was to make more MONEY.
          • bedast 4y ago
            You are among the people just learning about this class of drug. It's been around since 2004 (Byetta). I've been taking it since 2012 (Victoza). Even then, it was known to promote weight loss (Saxenda approved around 2014). This is not a new hotness. And many diabetics have used this drug class for a long time. And yeah, you're jumping into conspiracy theory. Ramping up production would likely take significant investment. Do they have the resources? Probably. But given the weight loss benefit is temporary (seriously, it is, ask anyone who has used one of these drugs for a significant amount of time), do you think they're going to sink significant investment into production when demand is going to wane in a few years? Well, you see, their investors are going to say no, and they hold the final say.
• wonderwonder 4y ago
  "Diabetes patients think people with obesity are stealing their drug, as it’s currently only approved for the treatment of T2D (though FDA approval for the treatment of obesity may come as soon as this summer.) People with obesity are angry that obesity isn’t recognized as a disease. And users who can’t afford it say they’ve been abandoned by Big Pharma." Always amazing when an article is verified in real time
  • bedast 4y ago
    It's weird for anyone to "feel abandoned by Big Pharma" when you abused a coupon to get a drug for off-label use, and terms were changed to match its on-label use. Especially when there's versions of these drugs with on-label use for weight loss.
    • somehnguy 4y ago
      Why should anyone need to use a coupon in the first place? Just charge a reasonable price, don’t make people jump through hoops for medicine.
      • bedast 4y ago
        Brand new drugs tend to take a while to get on insurance formularies. I believe Mounjaro is still missing in most formularies. Lilly wants people on their drug, not the competition.
        • somehnguy 4y ago
          So just yet another case of the American healthcare/insurance system being absolutely bottom tier in usability, profits for middlemen over all else.
          • spiralx 4y ago
            No, drug approval takes time everywhere with a health care system. Heck I've been on methylphenidate for my ADHD for almost 15 years now, and it's still off-label when prescribed to an adult in the UK according to the NICE.
• RobotToaster 4y ago
  The diabetes and obesity versions are pharmacologically identical, the only difference is the name and price. Off label prescribing is extremely common, to treat specific drugs as special in that regard is silly.
  • bedast 4y ago
    And dose. The doses are different. You need a much higher dose than is typically prescribed for diabetes to get the full weight loss benefits. Part of getting approval for on-label use of these drugs is understanding this part of it.
• walnutclosefarm 4y ago
  > Mounjaro is not an obesity drug. It's a type 2 diabetes drug. Do not call it an obesity drug This is an absurd argument. It's a drug. It has specific metabolic affects in humans that are valuable to people's health, among which are the control of blood glucose levels, and control of appetite and nutrient uptake, leading to loss of excess weight. That it is currently labeled only for Type 2 diabetes is a marketing decision by the manufacturer, not a characteristic of the drug. Or, to put this another way: the drug is doing exactly the same thing whether you measure its effectiveness with a glucometer, or with a bathroom scale.
  • bedast 4y ago
    > That it is currently labeled only for Type 2 diabetes is a marketing decision by the manufacturer, not a characteristic of the drug. Regulatory approval. It is a diabetes drug because it has been evaluated as such, including understanding the primary effects and side effects at various dosing levels. Mounjaro is prescribed to diabetics from 2.5mg to 15mg in increments of 2.5mg and titrated based on needs and goals. Typically, weight loss versions of these drugs (Saxenda and Wegovy) are dosed higher than their diabetes counterpart, and are just titrated to maximum dose over time to maximize weight loss benefits. So evaluation is based on this, and approval follows this. Various drugs do get used for off-label purposes, but the drug makers can't promote this because their marketing claims are regulated. This is why the coupon terms were changed.
    • runnerup 4y ago
      Mounjaro will have FDA approval for obesity this year. GP’s dogmatic stance that “Mounjaro is not an obesity drug!!” is soundly rejected by the available evidence.
      • bedast 4y ago
        Mounjaro will never be approved for obesity. The documentation for dosing is for diabetes. If the trend follows with how Novo Nordisk has released their versions of this, dosing for weight loss will be different than dosing for diabetes care, and so it must be under a whole new label. Mounjaro is a trade name for a diabetes drug and that won't change. So no, it is not soundly rejected. It's not as simple as "SQUIRT JUICE INSIDE ME GET THINNER AND CURE DIABETES". There's a lot more to this than you seem to understand.
• pwinnski 4y ago
  I'm aware that you're upset because of shortages in the medicine you need. I think your beef should be with the pharma company seeking to maximize profits by constraining supply such that they are easily overwhelmed by off-label use, not with people seeking effective medical treatment. There's a common meme among what I've seen from diabetics complaining about the shortages: that this is a tik-tok thing, or prompted by some celebrity, and the medicine is being take by people trying to lose ten lbs. I don't think any of that is true. Doctors are prescribing this for people who have medical conditions that make them dramatically overweight. My mother found relief from lipedema after decades of pain thanks to mounjaro, and she's facing the same shortages you are. She's done the half-doses and the quarter-doses and stretched them out until the pain came back. Mounjaro is the best drug for a number of conditions, both the approved diabetes and some number of not-yet-approved conditions. Eli Lilly is maximizing profits in a way that leaves people with Type 2 diabetes and other painful conditions suffering. There's no need to blame social media for Eli Lilly's shortcomings.
  • JaimeThompson 4y ago
    >Doctors are prescribing this for people who have medical conditions that make them dramatically overweight I know multiple people < 150 lbs who have gotten scrips for it with no history of diabetes.
    • Vecr 4y ago
      How tall are these <150lbs people? How old? Are they men or women? Do their doctors think they show signs of possibly getting diabetes in the future? Obviously if there's a 5'10" 25 year old male with negligible risk of diabetes, they should keep their current weight or even increase it slightly by changing their body composition from majority fat to majority muscle by doing exercise. If someone's short, old, can't exercise for some reason, and might get diabetes at some point, there could be a role for a drug there.
    • finneganscat 4y ago
      How many? Enough to make this comment anything other than a meaningless anecdote? I'm over 375lbs and nobody will prescribe it for me. There's my counter-anecdote.
• mise_en_place 4y ago
  I feel like you're splitting hairs. The intended purpose of GLP-1 drugs is to improve A1C in existing diabetic patients. Weight loss is directly correlated with that, because if your body is properly expending glucose, then the excess will not be stored as fat, or sit around in your blood stream in the case of diabetics.
  • bedast 4y ago
    Do you even know what A1c is? Or how GLP-1 RA achieves this goal? GLP-1 RA does NOT achieve a reduced A1c through weight loss. It achieves improved glycemic control by slowing the release of glucose into the blood as well as promoting increased production of insulin in response to glucose. The overall result is a reduction in blood glucose. A1c is a measure of your glycemic health that spans around 90 days with heavier weight on more recent trends. It's like a longer blood glucose average measurement. There are actually algorithms that can calculate an estimate of your A1c based on blood glucose trends, which is referred to GMI (glucose management indicator). The gastric effects leading to feeling full sooner and longer are a side effect and is what leads to weight loss. It also fades with time. Having been on various GLP-1 RAs over a decade, they don't provide this benefit to me anymore. Even with Mounjaro also being a GIP, it's just doing its primary job for me.
• anonuser123456 4y ago
  >Mounjaro is not an obesity drug. It's a type 2 diabetes drug. Do not call it an obesity drug. Mounjaro is a drug that causes weight loss. Is that better?
• anaisbetts 4y ago
  > Leave the diabetes drugs alone. Is artificially partitioning what is almost certainly the same medication (with the same manufacturing process) into two separate product lines actually a Good Thing? This means that when Mounjaro has supply problems even with the split, diabetics won't be able to get it because part of the supply is inaccessible to them since it is dedicated to a different "product". Instead we should advocate for the real solution, which is to demand the manufacturer drastically increase production - Mounjaro along with Semaglutide have literally capital-S Solved one of the most urgent health epidemics of the 21st century, and the solution isn't to shame people for using it, the solution is to make it available to anyone who needs it.
  • MichaelZuo 4y ago
    Who is this 'we'? I'm quite certain a large fraction of the HN userbase still believes that people can do independent business without being forced along one direction or another.
    • anaisbetts 4y ago
      What in the world are you talking about
      • MichaelZuo 4y ago
        > Instead we should advocate for the real solution, which is to demand the manufacturer drastically increase production -
  • bedast 4y ago
    Significantly increasing production for a temporary benefit is going to require significant investment. Since it is a temporary benefit, it's probably not worth that significant investment. Because eventually the demand will falter. And yeah, the weight loss benefit is a temporary benefit. It may last a few years, but it fades. This is not a new drug class. The weight loss aspect to it is also not new (Saxenda, the weight loss variant of Victoza, released in 2014). Liraglutide was in trials for weight management when I started Victoza. That was a decade ago. I'm on Mounjaro now for glycemic management and it works great for that. But it's not doing anything for appetite, delayed gastric emptying, etc.
• Animats 4y ago
  > Mounjaro is not an obesity drug. It's a type 2 diabetes drug. Do not call it an obesity drug. It's in round 2 of phase 3 clinical testing as an obesity drug, and will probably have full approval this summer.
  • bedast 4y ago
    Tirzepatide is in testing. The weight loss variant will not be called Mounjaro. If they follow similar patterns from Novo Nordisk with Saxenda and Wegovy, dosing will be different for the weight loss variant, which means it won't carry the same label.
    • Animats 4y ago
      They're the same chemical. The manufacturing process seems to be reasonably efficient. See "Kilogram-Scale GMP Manufacture of Tirzepatide Using a Hybrid SPPS/LPPS Approach with Continuous Manufacturing"[1] Yields are apparently good. There are drugs which require many processing steps with low yields at each step, and those really are expensive to make. But not this one, it seems. A kilogram of the stuff is about 100,000 to 200,000 doses, so this is not an inherently expensive material. Patent expiration in 2036. [1] https://pubs.acs.org/doi/10.1021/acs.oprd.1c00108 https://pubs.acs.org/doi/10.1021/acs.oprd.1c00108