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The active ingredient, tirzepatide, isn't what's new here. It was patented in 2016 and has been on the market for treating type 2 diabetes since 2021. What's n

by quux 3y ago

The active ingredient, tirzepatide, isn't what's new here. It was patented in 2016 and has been on the market for treating type 2 diabetes since 2021. What's new is that tirzepatide is now FDA approved for treatment of obesity, which will make it possible for insurance to cover it without a type 2 diabetes diagnosis.

bb88 3y ago
It should also be noted that during those original studies significant weight loss was observed, which is why doctor's were prescribing tirzepatide off-label. Also just like Ozempic/Wegovy, Mounjaro is still indicated for type 2 diabetes. Zepbound will be the weight loss drug.
- Obscurity4340 3y ago
  Can people still get insurance to cover stuff like Ozempic (generic or otherwise) even if its technically prescribed off-label?
  - bb88 3y ago
    Depends upon the insurance. The doctor can certainly prescribe it though.
    - Obscurity4340 3y ago
      Do you think there's a way to "compel" this availabillity by litigation via best practices or medical recognition of what the FDA recognizes as "Gold standard" for medications?
      - petesergeant 3y ago
        The problem isn't prescription in the US, the problem is whether or not someone's insurance will cover weight-loss medications as they're expensive. If you have the cash, Mounjaro was easily available to you in the US already for weight-loss, and finding a doctor to prescribe it wasn't (much of) a problem. The various subreddits concerned with this certainly talk about whether or not insurance should be legally compelled to cover obesity. Just to tack this on to "what's the gold standard", the gold standard is GLP-1 receptor agonists, and nothing before that has been anywhere near as effective without serious side effects. Things have basically been stimulants (phentermine, ephedrine), bulking agents (like fiber), things that mess with fat absorption (orlistat, which prevents it; olestra, which is a fat substitute), or treatments that reduce the active area of your stomach (bypass, stapling, sticking a balloon in your stomach). All are either ineffective or come with really bad side-effects. GLP-1 receptor agonists are really the only game in town, like Viagra was when it came out. The evolution has basically been (as I understand it): * Liraglutide / Victoza / Saxenda (works OK) * Semaglutide / Ozempic / Wegovy (works well) * Tirzepatide / Mounjaro / Zepbound (works great) In each case, they've been a diabetic medication that turns out to be great at weight-loss.
        bb88 3y ago
        And that's what's available today. Lilly has the so-called "Triple-G" shot in trials right now. Retartrutide shows even better weight loss potential than Tirzepatide
        Obscurity4340 3y ago
        To what extent do you think this addresses root causes? Like, does it physiologically compel them to be less hungry or what?
        petesergeant 3y ago
        Yes, that’s exactly what it does. My hunger is absolutely diminished, and my reward feedback from eating are also diminished.
        Obscurity4340 3y ago
        Is developing tolerance/dose escalation a prescient issue here?
        petesergeant 3y ago
        People move through the different doses at different speeds, and most people seem to find a stopping, long-term dose, but also there are people complaining that they’ve hit 15 and it’s starting to wear off. There’s also not a well-developed stopping protocol, other than “this is a drug for life but maybe start spreading out dosage”.

by quux 3y ago

bb88 3y ago

It should also be noted that during those original studies significant weight loss was observed, which is why doctor's were prescribing tirzepatide off-label. Also just like Ozempic/Wegovy, Mounjaro is still indicated for type 2 diabetes. Zepbound will be the weight loss drug.

Obscurity4340 3y ago
Can people still get insurance to cover stuff like Ozempic (generic or otherwise) even if its technically prescribed off-label?
- bb88 3y ago
  Depends upon the insurance. The doctor can certainly prescribe it though.
  - Obscurity4340 3y ago
    Do you think there's a way to "compel" this availabillity by litigation via best practices or medical recognition of what the FDA recognizes as "Gold standard" for medications?
    - petesergeant 3y ago
      The problem isn't prescription in the US, the problem is whether or not someone's insurance will cover weight-loss medications as they're expensive. If you have the cash, Mounjaro was easily available to you in the US already for weight-loss, and finding a doctor to prescribe it wasn't (much of) a problem. The various subreddits concerned with this certainly talk about whether or not insurance should be legally compelled to cover obesity. Just to tack this on to "what's the gold standard", the gold standard is GLP-1 receptor agonists, and nothing before that has been anywhere near as effective without serious side effects. Things have basically been stimulants (phentermine, ephedrine), bulking agents (like fiber), things that mess with fat absorption (orlistat, which prevents it; olestra, which is a fat substitute), or treatments that reduce the active area of your stomach (bypass, stapling, sticking a balloon in your stomach). All are either ineffective or come with really bad side-effects. GLP-1 receptor agonists are really the only game in town, like Viagra was when it came out. The evolution has basically been (as I understand it): * Liraglutide / Victoza / Saxenda (works OK) * Semaglutide / Ozempic / Wegovy (works well) * Tirzepatide / Mounjaro / Zepbound (works great) In each case, they've been a diabetic medication that turns out to be great at weight-loss.
      - bb88 3y ago
        And that's what's available today. Lilly has the so-called "Triple-G" shot in trials right now. Retartrutide shows even better weight loss potential than Tirzepatide
        Obscurity4340 3y ago
        To what extent do you think this addresses root causes? Like, does it physiologically compel them to be less hungry or what?
        petesergeant 3y ago
        Yes, that’s exactly what it does. My hunger is absolutely diminished, and my reward feedback from eating are also diminished.
        Obscurity4340 3y ago
        Is developing tolerance/dose escalation a prescient issue here?
        petesergeant 3y ago
        People move through the different doses at different speeds, and most people seem to find a stopping, long-term dose, but also there are people complaining that they’ve hit 15 and it’s starting to wear off. There’s also not a well-developed stopping protocol, other than “this is a drug for life but maybe start spreading out dosage”.