21 ms·
Wegovy could be covered for at least 3.6M people under new Medicare rules
- prepend 2y agoIt’s very expensive at $10k/year/patient, but I wonder if the long term costs are still cheaper than treating heart attack or stroke. Obesity greatly increases the risk of cardiovascular events so I think this may end up saving Medicare money by shifting to pharmaceuticals from emergency care. Of course, would be nice if they would negotiate a lower price as it’s really expensive. But Medicare covers other chronic preventative meds, PReP coming to mind and that’s like $10k/year. But still way cheaper than HIV treatment that it prevents.
- toast0 2y agoDepends on what the long term side effects are. Fen-phen reduced obesity for some, but the heart damage it caused made it more expensive than no intervention. [1] [1] https://en.m.wikipedia.org/wiki/Fenfluramine/phentermine https://en.m.wikipedia.org/wiki/Fenfluramine/phentermine
- deleted 2y ago[deleted]
- prepend 2y agoIt’s been in use for 20 years or so, so I expect we’ve discovered most long term effects.
- toast0 2y agoWikipedia said semaglutide was approved by the FDA in 2017. With later approvals in the EU, Japan and Australia. Was it approved earlier elsewhere? Use for weight loss is relatively new as well. Approvals for that use are more recent, but off label use preceeds approval.
- ceejayoz 2y agoFirst of the GLP-1 receptor agonists was https://en.wikipedia.org/wiki/Exenatide https://en.wikipedia.org/wiki/Exenatide in 2005 (with clinical trials prior to that). Safety profile is reasonably well understood with two decades under our belts.
- addicted 2y agoWasn’t it approved for people with diabetes? I’m assuming the tests were done on people with diabetes then. Were there tests done on non diabetic people as well?
- fransje26 2y agoAh, but that is the beauty of it you see. You can then also sell a medication to counter the heart damage.. Beyond the sarcasm, it is concerning that most comments read here are raving about how much of a positive effect this cure could have. From a quick scroll, I haven't seen any addressing the fact that a new pill is not helping solve the cause of the problem. We, as a society, have absolutely no reason to be obese. Yet, we choose to ignore the root of the problem, and cheer on the palliative chemical solutions. These solutions inevitably come we serious health side effects that we accept without blinking, as the most natural thing. And the industry also cheers as they can now also sell a second cure to address the side effects of the fist cure. It shouldn't be forgotten that the pharmaceutical industry is, fist of all, a business. https://arstechnica.com/tech-policy/2018/04/curing-disease-not-a-sustainable-business-model-goldman-sachs-analysts-say/ https://arstechnica.com/tech-policy/2018/04/curing-disease-n...
- sbelskie 2y agoHow is a drug that reduces appetite and eating not solving the root cause of obesity?
- _aavaa_ 2y agoBecause the root cause isn't a sudden increase in appetite. What caused people's appetite to increase?
- 015UUZn8aEvW 2y ago>Because the root cause isn't a sudden increase in appetite. It seems plausible that the introduction of evolutionarily novel ultraprocessed foods, designed by scientists in labs to be as tasty as possible, could increase a lot of people's appetites.
- _aavaa_ 2y agoI agree that they might create a positive feedback loop, see for example the ever-present sugar cravings that take a few days-weeks of no dessert or sugar to subside. The processed foods however is what we’d want to get rid of. Otherwise all we do is slow down the loop, and add in more side effects.
- rthnbgrredf 2y agoThe cost of 10k per year is very likely to drop over time, especially if there's a huge roll out for millions of people. I think statistics calculations will show a net positive effect in terms of long term health care savings, unless Wegovy has serious side-effects that counter the benefits.
- ceejayoz 2y agoMedicare is also now allowed to negotiate prices. I fully expect this one to be on the list ASAP.
- refurb 2y agoMedicare (the government part) wouldn't pay directly for Wegovy since it's an out-patient drug. That would be Medicare Part D, which is managed by private insurers who can negotiate.
- ceejayoz 2y agoNah. Drugs covered by Part D are precisely what they got the right to step in for. https://www.cms.gov/files/document/fact-sheet-medicare-selected-drug-negotiation-list-ipay-2026.pdf https://www.cms.gov/files/document/fact-sheet-medicare-selec... > For the first time, the law provides Medicare the ability to directly negotiate the prices of certain high expenditure, single source drugs without generic or biosimilar competition. Below is the list of 10 drugs covered under Medicare Part D selected for negotiation for initial price applicability year 2026, based on total gross covered prescription drug costs under Medicare Part D and other criteria as required by the law. https://www.medicare.gov/about-us/prescription-drug-law https://www.medicare.gov/about-us/prescription-drug-law > For the first time, Medicare will be able to negotiate directly with manufacturers for the price of certain high-spending brand-name Medicare Part B and Part D drugs that don’t have competition.
- maxerickson 2y agoThat the private operators of part D were always free to negotiate prices is most of the point.
- throwup238 2y agoFor comparison, (as far as I know) the drug with the most revenue per year is Humira which costs roughly the same per year and has several million customers globally.
- mchanson 2y agoBlue cross has $450 / mo negotiated rate. Medicare can do better than that and government has started doing negotiations for drugs.
- dogma1138 2y agoIt’s around £250 a month in the UK privately, when it falls under the NHS fully it will likely be even cheaper. There is absolutely no reason for it to cost $10K per year in the US. I’m more worried about the long term effects of it, we had plenty of “miracle drugs” in the past that resulted in significant damage long term to either those who took them or to their children.
- ceejayoz 2y agoGLP-1 receptor agonists have been pretty widely used for diabetes since 2005. If there's a major unseen gotcha lurking, it hasn't showed up in the first two decades. (Plus however long prior to that the clinical trials were going on for.)
- jrmg 2y agoFWIW, £250/month (GBP) is the equivalent of $3750/year (USD).
- mey 2y agoWith the right compounding pharmacy you can get it for less than ~$200/mo USD since Ozempic and Wegovy are the same drug, Semaglutide, just at a different dose. Is it "off label" use of Ozempic? Yes. Are the FDA and medical patents in the US broken? Yes.
- jnsaff2 2y agoIt's 88 EUR/month in my EU-Baltics country. I'd say it can be made much cheaper here and therefore in the US as well.
- pxmpxm 2y agoI think you're missing the fact that USA, as a very rich country, tends to subsidize drugs for everyone. Your cost is artificially lower as ours is artificially higher. The only way to make it cheaper in the US is to make your pay more.
- StefanWestfal 2y agoWould you mind to explain? My gut feeling tells me you are right but I can not follow 100%.
- jnsaff2 2y ago> The only way to make it cheaper in the US is to make your pay more. I think this is very unimaginative to claim that the developer/manufacturer costs are fixed in stone and THE ONLY WAY is for customers to zero-sum it amongst themselves. Most of the cost was in development/trials, the marginal cost of manufacture is probably in the single digits per month. With such an enormous market demand the development costs can be recouped faster and there is a possibility to lower the prices in the states as well. Also 10x difference points to more systematic differences in the healthcare systems not just altruism of the US citizens.
- tacocataco 2y agoCorporations are well known for selling things at a loss.
- viraptor 2y agoArtificially lower, as in getting lower profit, not as in subsidised. If you're trying to say corps sell ozempic at a loss, that's a big (citation needed).
- sn9 2y agoThere are several anti-obesity drugs in the pipeline that work through similar mechanisms that should be entering the market which should lower the price through competition. Heart disease, diabetes, and fatty liver disease are some of the most common killers and the reduction in excess body fat will causally and significantly lower the risks for all of them.
- akira2501 2y ago[flagged]
- xyst 2y agoI’m all for it. Initial results seem very promising, especially for those struggling to get to their target weights. I was initially skeptical of it especially given the massive marketing push for off label usage (reminded me of fentanyl/oxy or certain amphetamines for weight loss). Personally, just adjusting lifestyle (reducing intake of sugary and artificially sweetened foods; exercise; and intermittent fasting) over a sustained period of time (3-4 months) helped me drop 40 lbs. OTC supplements like vitamin d, and omega fish oil added to regimen (as recommended by doctor).
- temp0826 2y agoIt's very effective for sure. But I also think it's ripe for abuse. I've seen healthy people on it to lose only 10 lb instead of making slight changes. I don't think we know enough about its long term effects and how damaging it can be to be on severe calorie restriction for some periods of time. It's like an induced eating disorder in a way and I wonder about the psychological changes that accompany it.
- jstummbillig 2y agoWe should stop thinking of this complex in terms of "abuse" and "slight changes". We suck to varying degrees and obesity is obviously a societal issue. We need help. We should keep looking for better options, we can and should always keep an eye on potential consequences down the line — and we can always elongate that line — but the very real, proven consequences of being overweight/having high blood pressure can be calculated like those that are attached to burning coal and they are worth tackling without prejudice, within the guidelines of what good science deems safe. Anything we can do to help with cardiovascular issues needs to be explored. Doing otherwise would simply be immoral and irresponsible. We have tried eating salads and going for quick walks. It's always great when that's enough to change one person for the better. When it's not, we should help with empathy. Currently, there simply is no clearer, quicker path to doing more than these drugs, on a societal level.
- VS1999 2y agoI'm going to be skeptical of putting millions of on a new drug, permanently, to mask some underlying issue in society. Is there any evidence that people can be weaned off this after losing weight? Or is it expected to be permanent? This was not an issue in the past and whatever the root cause is, it's never going to be treated if we can just drug everyone into acting like they used to.
- blackeyeblitzar 2y agoI bet this will end up saving the government a lot more than it costs. On the other hand, the side effects and long term effects of these new drugs are not well known. I wouldn’t be surprised if some of the common GI side effects become something more serious.
- dandy23 2y agoWhy is it we can spend 10k/year on our car, but not 10k/year on ourself. We have to ask our government/insurance to pay. Makes no sense.
- 38 2y agoYou're in a bubble man. Not everyone is paying $800 a month for a car. Millions of people buy a cheap crappy car outright, and drive it for years.
- itsoktocry 2y ago>Not everyone is paying $800 a month for a car. Millions of people buy a cheap crappy car outright, and drive it for years. Not sure where you get "everyone" from, but look at the average car cost, plus insurance and fuel and maintenance; $800 is nothing.
- twojacobtwo 2y agoShow me the data with the average and median of all car purchases, not just new, and I'll show you that $800/mo is far from 'nothing'. Hell, my first 3 cars were under $4,000, with each lasting 5 years or better and I damnwell didn't spend anywhere close to enough on fuel and maintenance to bring my costs to even half that number. Maybe I'm an outlier, but in my bubble of poor folks, I'm certainly not.
- jrmg 2y agohttps://www.nerdwallet.com/article/loans/auto-loans/average-monthly-car-payment https://www.nerdwallet.com/article/loans/auto-loans/average-... The average monthly car payment is $738 for new cars and $532 for used. Several factors determine your payment. The data source is Experian, so I give it some credence. If you think it’s high, consider that all the low payments you know of need an ‘equivalently’ high payment to balance out the average. People spend huge amounts of money on cars.
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- citizenpaul 2y ago[flagged]
- histriosum 2y agoThis is a pretty biased take in my opinion. I personally know at least one person who has lost more than 80lbs on Wegovy, after not being able to lose weight for years. It's been a literal sea change for her life, at least.
- qbit42 2y agoDo you know anyone taking these drugs? They can dramatically reduce cravings for food - the effect is significant. Not to say there aren't plenty of valid concerns about such drugs...
- user_7832 2y agoAs someone taking another medication with similar effects, it can be hard to describe to folks who haven’t experienced how a “simple” tablet can reduce or kill hunger altogether.
- pavlov 2y agoIt’s a rigorously tested medication, not a fantasy. You can read the original FDA approval for the data highlights: https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014 https://www.fda.gov/news-events/press-announcements/fda-appr... “The largest placebo-controlled trial enrolled adults without diabetes. The average age at the start of the trial was 46 years and 74% of patients were female. The average body weight was 231 pounds (105 kg) and average BMI was 38 kg/m2. Individuals who received Wegovy lost an average of 12.4% of their initial body weight compared to individuals who received placebo.” These were multi-year trials with thousands of patients.
- Auracle 2y agoYou know, I know it works better for some but those numbers don’t seem great to me. If the average person is 231 pounds and loses ~28 pounds they’re still pretty darn overweight, if not obese. According to the study on their own website it looks like it levels off at about 68 weeks, which is where those numbers come from. So we’re paying $1,000 a month for most of the people that take it to stay fat, just less so.
- benjamoon 2y agoIt's about £2,500 ($3,100) per year in the UK if you just buy it online, not subsidised. I don't know how the US massive price hike is justified when the whole western world is buying it from the same supplier (Novo Nordisk in Denmark).
- wmf 2y agoThe US market is paying for the R&D while the rest of the world is getting it below cost.
- bpicolo 2y agoIsn't it made by a Danish company?
- kgwgk 2y agoPrices are higher in US than in Europe - whether the company is from Europe or the US doesn't change that.
- mchanson 2y agoProbably not.
- wjnc 2y agoI think this is mostly true. Perhaps truer still is that the US willingly had rules that massively reduced their market power in negotiations, which in a game of parallel negotiations leads to the obvious price discrimination. You cannot blame big pharma for giving a client willing to pay any price without negotiations what the client wants: high prices. One counterpoint is that in my country we’ve successfully reduced prices for medicines a lot by strong negotiations in the last decade. We are last in line among western nations for medicines now. Shortages all around.
- drpotato 2y agoDo you have a source on that claim?
- djsudysgcc 2y agoSay what you want but pharmaceuticals are perhaps the only hope America has against the obesity epidemic.
- toomuchtodo 2y agoOr GLP-1 pathway targeted gene therapy.
- djsudysgcc 2y agoInteresting is anyone doing it?
- toomuchtodo 2y agoFractyl Health. https://www.fractyl.com/fractyl-health-demonstrates-significant-improvement-in-glucose-control-and-obesity-inpreclinical-studies-of-its-rejuva-glp-1-based-pancreatic-gene-therapy-glp1-pgtxcompared-to-chronic-semaglutide-at/ https://www.fractyl.com/fractyl-health-demonstrates-signific... (no affiliation, just very interested in a permanent fix that scales vs chronic mgmt with a pharma product)
- djsudysgcc 2y agoTrial starting this year and listed on a stock exchange meaning there should be lots of good info disclosed ! Cool thank you
- jpk 2y agoThat's certainly a take, but without reasoning or evidence, this isn't a very interesting comment.
- ceejayoz 2y agoThe epidemic itself is pretty strong evidence. Gastric bypass and these new drugs are basically the only proven effective ways of reliably helping people lose.
- renewiltord 2y agoA friend of mine is earning millions of dollars / month connecting people to this drug. The trick is working out the insurance company rules. With Medicare they're going to be rich as fuck. Just a giant pump of taxpayer dollars into this. It's going to be fantastic.
- GenerWork 2y agoHow does this work?
- renewiltord 2y agoBought compounding pharmacies
- refurb 2y agoFDA is shutting those down
- renewiltord 2y agoHaha, interesting. You win some, you lose some.
- refurb 2y agoI should say shutting some of those down. A few have brought it to court and said “as long as there is a shortage this should be legal” and the court agreed. But the FDA really dislikes compounding because of the safety risks.
- insane_dreamer 2y agoWithout discounting the cases that are genetic or as a result of some other illness, for whom such a pill is a godsend, most obesity is due to lifestyle and especially all the processed foods (not to mention soda!) that Americans eat and drink. I'd rather my taxes go to preventing obesity in the first place then paying for a pill that helps relieve its symptoms (but does not fix the underlying cause), is expensive, and has side effects. Make it harder to life an unhealthy lifestyle, just as we've made it a lot harder to smoke over the past 40 years. Start by taxing sodas and processed foods for one and use the money to subsidize healthier foods and prevention of "food deserts" in lower income areas (given that obesity is highly correlated with low income which is highly correlated with unhealthy diet -- it's hard to stay healthy when all you have nearby are corner stores stuffed with Frito Lay and Coke. To me it's another example of how we really have our priorities backwards.
- airstrike 2y ago> To me it's another example of how we really have our priorities backwards. Not if your priority is to maximize shareholder value
- insane_dreamer 2y agoMy point exactly
- prepend 2y agoIt’s not that there are no other interventions for obesity, it’s just that this is the cheapest and most effective. If taxing sodas had the effect of reducing body weight by 1/3, then I’d be all for it. But behavioral interventions are really hard to stick. The reason ozempic is taking off is that it works given the systemic issues we have. It’s the equivalent of saying people shouldn’t take anti-depressant meds because we can just change systemic factors they cause depression. We can do both, but it’s not like we’d discourage food deserts instead of ozempic. We need to do both. And cynically, I think ozempic will work to reduce obesity.
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- balozi 2y agoInstead of spending money on Wegovy, spend the money on Novo Nordisk stock.
- glp1guide 2y agoNote that seniors are actually some of the biggest cohorts using the new GLP1 Receptor Agonists: https://glp1.guide/content/senior-citizens-and-glp1-receptor-agonists/ https://glp1.guide/content/senior-citizens-and-glp1-receptor... Also as some other people have noted, those costs seem high now, but they're certain to go down over time (due to competition and other companies entering the market along with other countries), and almost certainly worth the cost -- type 2 diabetes can be very expensive, along with all the other effects from complications of obesity. For example, Wegovy has actually been FDA approved for reducing heart disease risk: https://glp1.guide/content/news-fda-approves-wegovy-for-reducing-heart-risk https://glp1.guide/content/news-fda-approves-wegovy-for-redu...
- camhart 2y agoI've heard from random podcasts (do your own research) you need to make sure you exercise, and perhaps eat high protein, while on drugs like this, otherwise you lose a ton of muscle mass. Could be deadly for seniors, where falls are a leading cause of death. See https://www.ncoa.org/article/get-the-facts-on-falls-prevention https://www.ncoa.org/article/get-the-facts-on-falls-preventi.... This is not to say the drug is bad, simply to encourage education so we dont trade one problem for another.
- glp1guide 2y ago> I've heard from random podcasts (do your own research) you need to make sure you exercise, and perhaps eat high protein, while on drugs like this, otherwise you lose a ton of muscle mass. Could be deadly for seniors, where falls are a leading cause of death. This isn't true in the sense that it's because of GLP1 RAs in particular -- it's just that GLP1 RAs are effective at rapid weight loss, and that's what happens when you undergo rapid weight loss REGARDLESS of method. It's a trade-off -- do you want to manage muscle loss and bone density issues (with an easily modifiable dosage/etc) or manage type 2 diabetes or heart disease for the same patient?
- syndicatedjelly 2y ago[flagged]
- ceejayoz 2y agoDoes no one remember what happens when we don’t have effective pharmaceuticals at all? I balance vague dark assertions of conspiracy against the clear issues obesity can cause the health of the population. I’ve got a loved one who needed a gastric bypass; I’m glad there are less invasive options available now.
- indigo0086 2y agoLike most problems we've accepted them as a base layer (obesity is inevitable because decades of SAD diet proliferation from homes to public schools) so the only solution are pharma drugs, elective surgeries and subsidies of those. Basically we ignore or find new ways to define the base layer as to accept it as nature, and pharma is the cure to these defects of natire
- naveen99 2y agoMaybe insurance should cover if an obese person is already walking 10000 steps per day for a year and not able to lose weight.
- manquer 2y agoWhy ? Leaving aside the obvious issue of humanity and basic decency, You are paying for the insurance no matter what anyway due to all the related illnesses [1] from obesity Should now insurance not cover heart attacks or diabetes or other illnesses strongly correlated with weight for obese people ? Where does that stop ? When is it not fault ? Should insurance not cover if you injured in sports(been careful) Or work place injuries (choosen a different job ) ? [1] this is the same dumb deserving argument for uninsured, they are still getting treated in ER usually repeatedly when it would be cheaper to cover them
- bequanna 2y ago> this is the same dumb deserving argument for uninsured, they are still getting treated in ER usually repeatedly when it would be cheaper to cover them This is a myth. Insurance is low-cost or usually free for all low income people in the US.
- manquer 2y agoI would say that insurance is low-cost or free for anyone is the myth. Since the emergency over Covid was declared over last year, the number of people and kids being kicked out of Medicare and Medicaid ostensibly because of procedural issues or some imaginary fraud has been constantly in the news. The forever argument on the right is link coverage to employment or some other ridiculous reason deserving reason invoking the welfare queen caricature, just last week John Oliver did a segment on this .
- bequanna 2y agoI didn’t say it was low cost or free for everyone, only low income people. I’m sure you can dig up some exceptions where someone was denied coverage for some reason or bureaucratic screw up, but my above statement is broadly true. Also, I wouldn’t consider John Oliver a good source for anything. His show is biased infotainment pandering to a specific group.
- bushbaba 2y agoThat’s a solid 12k+/year for eligible patient. Have no issue so long as it’s capped to an order of months to avoid it being a forever med. otherwise we’ll see all our insurance premiums and Medicare taxes rise dramatically.
- ceejayoz 2y agoNow, do the math on leaving obesity unchecked. Hip replacements, heart attacks, diabetes… Medicare should easily be able to negotiate some volume pricing, now that they’re legally permitted to finally.
- andrewstuart 2y agoWhere in the world is this even available? Not to be had at any price in Australia.
- ceejayoz 2y agoThe manufacturer is buying every plant they can get their hands on. With this amount of money at stake, they'll manage it pretty quick.
- nisegami 2y agoThere goes my chances of getting any for my diabetes this decade :(
- syngrog66 2y agothis should not be on Hacker News