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The Maker of Ozempic Is Trying to Block Compounded Versions of Its Drug
- Molitor5901 2y agoCompounded drugs have a difficult line to walk. AFAIK, compounded drugs are those which are made custom to the patient due to allergy, or unavailability. The concern is when a compounding pharmacy makes a drug that already exists on the market, but the pharmacy sells it anyways even though it's identical, or at a lower cost.
- encoderer 2y agothe modern twist is that large health startups like Hims and 23andme are getting into the compounding business and the drug makers arent happy to have the competition.
- Something1234 2y agoHims bugs me a lot with these compounded all in one masculinity drugs. We don’t know the effects of mixing the timing of these drugs in one shot.
- encoderer 2y agoTruly I think male pattern baldness drugs are poison and hims is probably a net negative for society at this point.
- parhamn 2y agoWhich?
- drawkward 2y agoThe one (and only) time I filled a prescription for propecia a couple decades ago, one of the warnings said something akin to: pregnant women should not even touch a broken propecia capsule due to the risk of birth defect. After that, I decided to just allow nature to take its course on my hairline.
- chimeracoder 2y ago> The one (and only) time I filled a prescription for propecia a couple decades ago, one of the warnings said something akin to: pregnant women should not even touch a broken propecia capsule due to the risk of birth defect. Lots of drugs are bad for pregnant and/or nursing women. Propecia is not particularly special in this regard, nor is it especially dangerous compared to all the other drugs out there which are also bad for pregnant women. "Do not handle" is a warning for topical formulations, just because those are intended to be absorbed transdermally.
- encoderer 2y agoI got finesteride from them and used it for a couple months. Stopped taking it and my nuts ached for almost 2 weeks.
- candiddevmike 2y agoHims strikes me as a giant liability lawsuit just waiting to happen. The things they are selling should never be advertised/sold that recklessly. All they're doing is playing on folks insecurities and potentially giving them serious medical issues down the line due to their willful negligence with prescribing/distribution
- BobAliceInATree 2y agoThere's also value in individualized dosing. I take tirzepatide, and 5mg is too intense for the first couple days, but 2.5 doesn't last long enough. Ideally I'd take 2.5 every 4 days, instead of 5.0 every 7 days, but that option doesn't exist, but is something that compounding could provide. But I'm not willing to risk the safety-murkiness of compounding, so just stick with the 5.0 and deal with it.
- cj 2y agocompounding veterinary medication was also common during Covid during medication shortages. It’s a way to get the same medicine just through different suppliers and circumventing various restrictions/regulations, and then prepared by the compounding pharmacy for ingestion by the patient. Common use cases are, in animals for example, you might need to put a dog a medication and the supplier may not manufacture the right size dose (or maybe your animal won’t eat pills so the compounding pharmacy reformulates it into a liquid) My veterinarian recommended sticking with brand name meds for my dog even though I was having trouble due to the size of the pill. Her reasoning was compounded equivalents simply aren’t tested in any medical or academic trials, only brand name formulations are tested in trials, so there’s no guarantee of efficacy since you’re literally taking a formulation of a medication that has gone through zero scientific testing (the isolated ingredients or a similar formula may have trials and testing, but not the exact formula you’re taking) Which is also why no compounded drug can be FDA approved. Logically I want to trust compounding pharmacies and I want to believe the efficacY and side effects are equivalent to name brand. But the fact that my veterinarian cautioned me against compounding my dog’s medicine gave me pause about compounding medicine for myself…
- hinkley 2y agoAt one point I was going to a human compounding pharmacy to get drugs for my cat. I don’t even remember what it was but they put it in fish oil to make it more palatable. Did not work.
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- mrgoldenbrown 2y agoIt's frustrating that nobody actually offers evidence for the drugs either being available or unavailable. Can Nordisk point to a warehouse with enough available supply to meet the capacity that the compounders are cranking out? Or can the compounders point to a bunch of customers waiting on unfulfilled shipments from Nordisk?
- unsnap_biceps 2y agoMy understanding is that they're almost completely separate customer bases right now. Ozempic is (generally) only approved by insurance when used as a diabetic drug and off insurance, it's in the $1000/month range. Weightloss folks are shit out of luck for insurance coverage, and so they go to compounding pharmacies and pay in the $200/month range. Forcing them to ~5 times the price will have a lot of folks unable or unwilling to do so and demand will drop.
- generalizations 2y agoI also know of people who travel to Guatemala to source it.
- deleted 2y ago[deleted]
- AnarchismIsCool 2y agoInteresting that the insurance companies aren't interested in supporting weight loss, the complications from being overweight are gonna be a whole lot worse than getting the drug. Did someone run the tables and find that obese people are dying too quickly to end up with medical bills?
- istjohn 2y agoI imagine there is too much churn for insurance companies to be able to be confident that they will be the ones to benefit from lower long-term health costs and not Medicare or some other insurance provider.
- gurchik 2y agoThe patent for semaglutide doesn't expire until 2030 (in the US), so a generic is not currently available. I say this as someone who is looking into purchasing the drug: I don't think many people buying the compounded formula know it is not a "generic" and is not FDA approved. The companies selling it often do not even say where it comes from. It shouldn't be surprising that Novo Nordisk is fighting these compounding pharmacies that are purely interested in undercutting them. Not to say they need our sympathy, since I'm sure a significant cost of Ozempic is due to the injection pen with a million patents.
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- toomuchtodo 2y agoThe pill version is showing similar safety and efficacy profiles as the injectable (leveraging higher dosage to get through the gut to the bloodstream), so runs to Canada and Mexico are probably in consumer futures to evade patent regulatory capture until 2030 (or getting it mailed from India, I have had personal success with this for other non controlled pharma products).
- Someone1234 2y ago> The pill version is showing similar safety and efficacy profiles as the injectable The pill, Rybelsus, barely works. They've having to put 700%+ more than the injections to still get a lower overall effectiveness. They're actively working on alternative delivery methods to resolve this. A daily pill GLP-1 will be a massive commercial success. Rybelsus isn't very good for either the manufacturer or the consumer. You're burning a lot of expensive peptide to get a worse outcome at every dose level.
- toomuchtodo 2y agoPerfect is the enemy of good enough. I agree with your assessment, that a pill is not ideal current state of the art, but if a pill format improves compliance and delivery vs injectables, and the cost of the pill can be driven down to where it is similar to Metformin, the outcome is still the same (even if there is waste from a suboptimal delivery mechanism). An efficient drug delivery mechanism you can’t get into the hands of a broad population cohort is not efficient. We are optimizing for accessibility for everyone who needs access to this drug family (imho).
- firesteelrain 2y agoI take tirzepatide, cut down my calories to about 1500, walk 4-6 miles a day, and exercise 3 times a week. With the help of tirzepatide, I have been able to curb the cravings. I have lost about 25 pounds so far with 25 more to go. I always understood that it was on shaky ground however pay the $350/mo to get 5 mg of tirzepatide. My work has a Medical Weight Loss program that uses semaglutide instead which is free. I plan to switch to that. If it becomes unavailable, then I will have to switch back to regular discipline, food tracking, exercise, etc that I probably should have did all along. I will do whatever I have to do in the meantime to safely lose weight.
- hinkley 2y agoIt’s a lot easier to exercise when you weigh 30 lbs less. Runners claim more than 2 seconds per mile per pound.
- chrisfosterelli 2y agoIt doesn't get easier, you just go faster.
- szundi 2y agoIf you go for your 5km, then all in all, it's easier (you are done sooner)
- freestyle24147 2y agoYou'll have to define easy. If you go faster, that means you're outputting more wattage per second. You may get there faster, but you've used up the new capacity that your body has developed so you're back to what are likely similar levels of discomfort. By your definition, Usain Bolt running the fastest 100m time ever set by a human is having an easier time than me because I do it slower. What most people mean by easier is that it "feels" easier: this would be accomplished by aiming to take the same amount of time even in the face of capacity increasing.
- AnarchismIsCool 2y agoLets be clear on how all this works. Someone made a drug, and they want all of the money for their work. Maybe that's justified, maybe it isn't. But because we use money as both our dopamine reward and also the entire basis of how we allocate all scarce resources in our finite reality, and because patents are the only way for them to get said dopamine reward/resources, the strat is to just let millions of people sit in the crossfire while we work out what kind of money they should get.
- throwawaymaths 2y ago> patents are the only way for them Citation needed.
- okasaki 2y agoToo bad there's no drug that cuts down on greed.
- carlmr 2y agoI read that Ozempic works against all cravings, even addictions. Maybe we can cure money addiction.
- mrguyorama 2y agoIf ketamine can't chill these people out, I'm not sure there's a chemical solution. Their brains might just be yet another neurodivergency.
- CatWChainsaw 2y agoThey come back from ayahuasca trips thinking they've unlocked some profound knowledge after experiencing ego death but in the end they just tweak what they were doing before and add fresh wise-guru paint to their operation.
- candiddevmike 2y agoSSRIs are commonly prescribed for hoarding disorders.
- InTheArena 2y agobear in mind, Ozempic is dramatically more expensive in the USA then any other country. The Pharma company has explicitly decided to price-gouge the United States. USA is 1300 versus 300 in canada. https://www.healthline.com/health-news/heres-how-much-more-ozempic-costs-in-the-u-s-compared-to-other-countries#Cost-of-Ozempic-and-similar-drugs-in-the-U-S-compared-to-other-countries https://www.healthline.com/health-news/heres-how-much-more-o... So yeah, fsck these guys. I have _zero_ problems in that context with the compounders here.
- slowmovintarget 2y agoIt's worse. They want Ozempic for all through Medicare. At those prices that's 3 trillion dollars. As RFK Jr. put it, for $3T we could give every man, woman, and child in the United States three organic meals a day. Or pay for gym memberships, which would be even cheaper. The President could issue an executive order saying Medicare won't pay a higher price than EU nations or Canada. If they want to raise their prices there, fine. But we're not going to be the ones paying through our nose because you think the American taxpayers have bigger bank accounts.
- switch007 2y ago> They want Ozempic for all through Medicare. Right. It seems pretty obvious who is behind all these media articles proposing these drugs being given to all overweight people.
- nradov 2y agoThe President has no statutory authority to issue such an executive order. We don't live in a dictatorship.
- slowmovintarget 2y agoMedicare is provided by the Department of Health and Human Services, which is part of the Executive branch of the U.S. federal government which is answerable to... the President. We don't live in a dictatorship, but the President absolutely has the power to say how much Medicare is willing to pay for a particular drug. President Biden could do this today, if he chose. The President can't say how much pharmaceutical companies may charge. But that's not what we're talking about here.
- heythere22 2y agohttps://archive.ph/hrnrO https://archive.ph/hrnrO
- tuumi 2y agoI purchased four 5ml bottles of semaglutide from China for $50. It's available at underground lab steroid sites and easy to find. Many people are ordering this and getting them tested and the results are posted. I realize the risk.
- asdff 2y agoWhy not just exercise?
- jf22 2y agoBecause it's not that simple.
- cthalupa 2y agoYou can't exercise out of being fat. It's a hugely important thing to do for your health in general, but the amount of effort needed to counteract the modern diet via exercise is absurd. The alternative is eating better - better food, less calories. But for a lot of people, they have tried and failed to do this for years. Even people that have had a history of being able to do this successfully can find themselves struggling. And once you're fat, the feedback loops kick in and make it more and more difficult. Is it within everyone's power to not be fat? Yes. Is it significantly harder for some people for a variety of reasons? Also yes. So we could act like this is a moral failing and fat people should just be fat until they manage to scrape together the willpower to ignore their body pushing them to eat, or we could recognize that these medications are extremely effective at helping tame those signals their body is sending. (Plus seeing a tons of other positive impact on things like fat deposits in the liver, insulin resistance, cardiovascular protection, sleep apnea, etc. - and these are seen even before significant weight loss occurs.)
- Someone1234 2y agoThese medications aim to reduce the addictiveness of foods. A very apt analogy is nicotine gum/patches. This is that, but for food (although early studies also show success for opioids and alcoholism). I feel like there is a lot of hypocrisy going on around this. People asking overweight/obese people "why not just eat less?!" and people responding "GLP-1 medications help me do just that," and the critics essentially saying "it is unfair fair that this drugs helps you do the thing I claim I want you to do." Also, calorie restriction, not exercise is what successful people use to lose weight. Exercise is highly recommended and will help you live a long and healthy life, but it won't help an Obese person loose >20 lbs of body fat. TDEE and calorie restriction will though.
- mmanfrin 2y agoI'd be more sympathetic if they actually met the demand of their prescribed base. I have about a 40% success rate actually getting my rx filled and have to use compounded versions.
- mrweasel 2y agoMy feeling is that Ozempic, and Wegovy, has been prescribed to too many, to fast. It was always clear that Novo Nordisk would not be able to the need of both diabetics, people who truly need to lose weight and those who just want to lose weight. The latter group should not be serviced at all at this point. Starting to push Wegovy was just a money grab, Novo must have known that it would disrupt their delivery of Ozempic.
- consteval 2y agoThe venn diagram of people who are diabetic and people who need to lose weight are almost a circle. If you're drastically overweight and not diabetic, that's because not enough time has passed. What people fail to realize is that obesity correlates highly with pretty much every bad thing you can develop. The faster you control obesity, the lower your risk will be. Virtually every organ in the body, from liver to kidneys to heart to lungs, is negatively impacted by obesity. I view it as people taking those drugs pre-emptively. They would require them, eventually.
- downrightmike 2y agoCompounding exists to fill the market gaps
- downrightmike 2y ago[flagged]
- bognition 2y agoIt's great and I'm happy for you that you have a body that is such that you can do that. Many people do not have similar experiences. Often times people who are not able to do things like are labeled as having a lack of control or a failing in the character. The truth is that many people have different chemistry which makes doing something like this borderline impossible.
- downrightmike 2y agoIts pretty much my only option, I asked for help years ago and doctors just don't give a shit.
- fasteddie31003 2y agoI'm curious as to what steps are taken to compound Ozempic? Could I try this at home?
- BearOso 2y agoThey're buying semaglutide salts from China and mixing it into distilled water. It's not that difficult. I wouldn't trust the sources to be pure and not doped with something else though. You're taking an even larger risk with an injectable.
- cthalupa 2y agoIf by compounding you mean producing semaglutide, no. If you have a source to buy lyophilized semaglutide and some BAC water, you could certainly reconstitute it yourself and pick a dosage, or compound in some vitamin b12 or similar. In practice for an average person, this means either buying them as research chemicals directly from china, or from resellers that mark it up by 10-50x. You might get a COA that testifies the chemical in question and it's purity level for that batch, and maybe that COA will actually match the batch in your vial. But you almost certainly won't get any guarantee on sterility. And there are reports of the contents of vials getting mislabeled, so people got entirely different products. You can try to counter some of the sterility issues with filter syringes, etc., but you're only mitigating some risk, not eliminating it.
- mschuster91 2y agoAssuming you can get your hands on actual raw semaglutide and know what you are doing, absolutely. It's not rocket science, drug dealers do that all the time. Pill presses can be had on Alibaba for a few hundred bucks and you can order virtually anything from "research chemical" online stores as well. But it is not risk free either. Contaminations of all kinds are the worst issue (particularly with anything supposed to be injected, so never try it with insulin...), but the most pressing one is agent distribution. That's what causes a lot of people to OD on stuff cut with fentanyl - if the fent, the actual drug (say, heroin) and the fillers aren't properly mixed, you may end up with a bunch of pills with far higher doses than intended while other pills essentially consist of pure filler.
- andrewla 2y agoI have to admit that I'm baffled as to what is happening here. Semaglutide is still under patent protection, so anyone producing feedstock is doing so under license with Nova Nordisk. Why on earth would NN offer licensing terms that allow them to sell the feedstock to anyone but NN? There are no generic manufacturers because the patent is still active. Compounding pharmacies are getting the drug from the feedstock producers, but how on earth are they contractually permitted to sell it?
- sithadmin 2y agoYour usage of the term 'feedstock' here is confusing, and it seems like you're probably operating under the erroneous assumption that contract manufacturer supplies commissioned by Novo Nordisk are somehow being routed to compounding pharmacies, which isn't the case. In practice, there are generic manufacturers for semaglutide, and many other peptides still protected by US patents, mostly located in China. The more reputable of these manufacturers produce these drugs at levels of purity rivaling the 'name brand'. These manufacturers export lyophilized product en masse to middlemen that operate in the grey/black-market 'research chemical' sales market, or ship to compounding pharmacies. The consumers purchasing on the grey/black market reconstitute the drug at home (which requires a trivial level of effort), and assume some extra degree of risk in terms of product purity and sterility. Consumers wanting an extra level of assurance for product quality purchase from a compounding pharmacy that ostensibly is conducting its own assessments of product purity, and following best practices for sterile reconstitution.
- andrewla 2y agoI don't think this is true. Henry's, one of the compounding pharmacies, says that they get the chemicals from legitimate licensed producers of feedstock [1]. There is a compounding loophole, but there is no loophole for patent encumbrances -- if a compounding pharmacy is violating NN's intellectual property, then can just sue them directly; they don't have to pursue the regulatory crackdown they're going for now. There are companies that do grey/black market reconstitutions, like Pivotal Peptides. But they are not compounders. The compounders are legally selling the real thing directly to customers. Do you have a specific source that indicates that any compounding pharmacy is getting its feedstock illegally from China? [1] https://www.reddit.com/r/henrymeds/comments/1av14cm/comment/kr9ggwr/ https://www.reddit.com/r/henrymeds/comments/1av14cm/comment/..., discovered via https://www.astralcodexten.com/p/the-compounding-loophole https://www.astralcodexten.com/p/the-compounding-loophole
- brcmthrowaway 2y agoCan ozempic help one get shredded?
- cthalupa 2y agoThere are a lot of bodybuilders using it to assist with cuts, yes. They're largely focused on retatrutide at the moment, though, since it seems to be more effective and they're a group that already is comfortable injecting themselves with substances they've acquiring from grey or black market sources.
- RickJWagner 2y agoI have a family member that went on Ozempic. After decades of suffering with weight problems (and resulting health issues), Ozempic brought about life-changing results in months. It is a fantastic drug, and I hope it becomes widely available as soon as possible.