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The Ozempocalypse Is Nigh
- deadbabe 2y agoCan someone please explain the economics of GLP-1s? How can people pay $1000/month for the rest of their life, just to keep weight off? Rent and mortgages are already insane as is, and then there’s insurance, kids, etc.
- noduerme 2y agoKnowing a couple people who've done it, they do it for a few months to lose weight, then stop taking it and try not to gain the weight back. I don't know anyone who's chosen to go on it permanently.
- doctorpangloss 2y agoThe drugs have been cheaply and widely available for a little over 17 months, and by some measures, about 1/3rd of patients prescribed semaglutide or tirzepatide are forecasted to be using either permanently.
- SkyPuncher 2y agoI'm doing essentially right now. Not big by any means, but loosing 20 to 30 pounds would be amazing for my joints. For me, I've been at a stable weight for over a decade. I figure if I can drop down over a few months, I can stay at my target weight.
- Mutjake 2y agoWell, it’s a medication designed for diabetes (the weight loss variant has a higher dosage and different brand name, Wegowy or so), and for diabetes the usage is, by default, permanent. Unless it is replaced by other medication or if the lifestyle changes make the insulin resistance not be an issue any more.
- oatmeal_croc 2y agoFew people actually pay 1000/month. Most get it through insurance (I pay 25/month), and most of the remaining get it through compounding pharmacies like HenryMeds which comes out to 300-400 per month. In fact, I know a few people who get brand pills (Rybelsus) mailed from India, where it's much cheaper. This insane pricing is a US only thing.
- doctorpangloss 2y agoRybelsus doesn’t work.
- oatmeal_croc 2y agoOf course it does, it is just much less effective than the injectable versions.
- alabastervlog 2y agoFurther, as noted in TFA, it’s possible to get higher doses at the same or almost the same price, though a compounding pharmacy, because pricing is basically the same no matter the dose (the materials are dirt cheap, the drug is very cheap to make, so they sell “the drug’s effect at however much you need” not “this amount of the drug”, basically) and then stretch it by taking smaller amounts than prescribed, or split a prescription with someone else.
- woleium 2y agoThey don’t. If you live outside of the USA it is cheaper (e.g. 400 cad a month in Canada) The article also mentions the grey market, where you can buy a year’s worth of power from China for a couple hundred bucks. You do need to be able mix it up properly though.
- black_13 2y ago[dead]
- jandrewrogers 2y agoAmericans are wealthy and don’t even realize it. The median household has >$1000 left over each month after all ordinary expenses against income, per the US government’s own data and statistics. Not everyone can afford it but a large percentage can. They may value this more than many other things they can waste that excess income on. The drugs are only going to get cheaper with time.
- chneu 2y agoIt's easy for Americans to think they're poor when half the country buys into a false version of reality where crime is rampant, the economy is constantly failing and welfare queens are eating your dogs.
- ergonaught 2y agoMost people I know using it were using insurance, so paying much less than that, however for many of them the insurance companies are dropping coverage for it. That had pushed some to the compounding, and thus ozempocalypse as that avenue is removed as well.
- unsnap_biceps 2y agoI can afford 1k/month and will if that's what's required. My life is well over 1k/month better with a healthier weight. I preform better at work, I'm happier, and I should live longer. That's worth the money.
- the_third_wave 2y agoOr you eat less and/or healthier food to achieve the same result without the side effects. Spend part of that $1000 (but not too much) on better food which you (or someone in your family) prepares at home, keep the rest for other purposes. For some reason this suggestion, i.e. the suggestion to solve a problem by eliminating the root causes, does not seem to be popular on this forum. I'd very much like to know why this is given that this place is supposedly frequented by rational people. If eating too much unhealthy food is making you fat you don't solve that by putting a chemical stopper in your veins, you solve it by eating less of the bad stuff.
- trogdor 2y agoI don’t think anyone here disagrees with the premise that fat people can lose weight by eating fewer calories than they expend. What you are missing is that — for many people — your solution is akin to telling an alcoholic to just drink less. Yes, it would solve their problem, but for a variety of reasons it’s probably not gonna happen. Most fat people who want to lose weight have already tried eating less food. Just like many alcoholics have tried to cut down or stop drinking. Some of those people succeed, but many others don’t. The reasons why are far more complex than commitment and willpower.
- JoeAltmaier 2y agoDeliberately disingenuous? Pretending it's a diet problem, and not a psychological one. Try this experiment: put a gun to your head and pull the trigger. You may find it hard. Your hand may shake; you will start sweating; rising panic will cloud your thinking. But it's so easy! Just a couple pounds of pressure on the trigger. Anybody can do it. That's me substituting a physiological problem for a psychological one.
- 2y ago
- alabastervlog 2y ago1) Any number of ways, they don’t pay that much. Or, 2) They’re rich. Not even that rich. I mean hell we paid $1,500/month for two kids to go to preschool, for years, and that sucked but we could still save. And we had a household income of like $130k or so at the time. Doing fine, not saying we didn’t have alright income, but not that uncommon. Now imagine a two-FAANG income like many folks on here. $1,000/month, even times two, is entirely within reach for them. Also, 3) You can go off it for periods and just go back on if the weight starts to creep up. Anyone who’s successfully maintained weight for periods in the past may be able to manage long stretches without it and not gain much. And further, 4) It’s not going to cost that much for long, in the scheme of things. The price will likely settle in the tens of dollars per month when the patents expire.
- timewizard 2y ago> but not that uncommon Taking in nearly double over the average household income is, by definition, uncommon.
- yimby2001 2y agoI think that’s a pretty average income for a couple with two children
- jwiz 2y agoMedian household income is like $80k
- novemp 2y agoIn San Francisco, maybe.
- disgruntledphd2 2y agoYeah but the OP lives there, and many people around them make similar or more, so it seems normal. This is incredibly common in many parts of life, humans gonna human I guess.
- bsder 2y agoPeople who need statins are on them for the rest of their life. People who need blood pressure regulators are on them for the rest of their life. Why should GLP-1s be any different?
- toast0 2y agoThere are a lot of very inexpensive statins and blood pressure drugs (not all of them, of course). $1000/month seems like a lot. Although if you end up eating significantly less, there's some savings there.
- lotsofpulp 2y agoTheoretically, a lot (most?) of healthcare costs are downstream of being overweight. Going to the doctor for diabetes, hypertension, knee problems, and the long term effects of those might be less costly than a constant subscription to purchase GLP-1s. Bonus is you no longer crave expensive sugary or alcoholic drinks and food.
- dragonwriter 2y ago> How can people pay $1000/month for the rest of their life No one actually pays that price. The $1000 misrepresented in the article as the "usual insurance price" is actually the list price, from which insurers negotiate discounts (that is, the full price -- not just the out of pocket price charged to the insured -- for insured patients is significantly less than that $1000 price), while most people who get the drug outside of insurance get it through some program (if it is the actual, brand-name drug, run by the manufacturer) that also charges much less than the list price.
- scarab92 2y agoIt seems like the entire US medical system runs on prices that no one actually pays. I don't really understand what all that extra complexity achieves?
- kashnote 2y agoThe sellers can write it off as a loss. It’s a way to avoid paying taxes
- nazcan 2y agoWhat does this mean? You don't get to write off the difference between your "target price" and actual sale price. And a reminder that companies always do better if they make more money, not point in purposeful losses (unless you are getting a side benefit like goodwill from charity).
- chneu 2y agoI think, but am not sure, the point they're trying to make is that hospitals and insurance companies can "charge" really high prices and then they can forgve those high prices in exchange for a tax break? That's not at all how it works so they don't have any idea what they're talking about. This is like when people say businesses can "write it off on their taxes". Only people who don't know what that really means say it.
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- fragmede 2y agoSay it costs you $300/mo for the GLP-1, but it saves you $300+/mo in groceries/snacks from the gas station/eating out at restaurants/alcoholic drinks at a bar, it's pretty easy to explain the economics.
- wewewedxfgdf 2y agoI'm far from convinced that some random "compounding pharmacy" produces effectively the same thing as Ozempic.
- oatmeal_croc 2y agoThe thing is, GLP-1 isn't that hard to make, and these compounding pharmacies make effectively the real thing.
- SkyPuncher 2y agoEven further, most drugs aren't _that hard_ to manufacturer. The hard part is discovering them and proving they're safe and effective.
- unsnap_biceps 2y agoCompounding pharmacies existed before Ozempic and their entire business model is producing custom drugs at reasonable prices. For Ozempic, they order the GLP-1 peptides from a large Pharma company and then mix it to order with bacteriostatic water and any other additives. Mine includes a B-12 compound that is attempting to help with the weight loss. They are highly regulated and require trained and licensed employees. The compounding pharmacies I don't trust are the ones that only started to do Ozempic and nothing else. But I do trust my local one. They've made me medication for my animals for decades now.
- doctorpangloss 2y agoThe status quo was pretty good for the FDA. Lily and Novo Nordisk still saw major stock price rises. Patients had super cheap drug options for something that would free up lots of money for non-medical spending in the economy. Why does an administration ruling via EO not keep the compounding loophole? It aligns with their goals. IMO, the compounders need to turn this into a media sound bite sized win for politicians. Because it certainly doesn’t make any scientific or objective medical sense to cease the compounding.
- jmward01 2y agoThis is actively improving health outcomes for millions of people so of course insurance won't cover it and it is being taken away from consumers. If the shortage is over, why does it cost $1k or even $500? Sounds like there is still a shortage to me. I guess vaccines are out but price gouging is still in in the US healthcare system.
- monkburger 2y agoProfits over patients. Pharmacies have to have crazy high prices though because PBMs reimburse at such shit rates, based on some percentage of the price given to them. Because if they buy the bottle at $30 and list the price at $60, the PBM contract will only reimburse at the adjusted wholesale price (another made up number), eg: 17% plus a $1.99 dispensing fee. This disgusting math results in getting a loss on the drug. Even all this leaves out some of the most absurd abuses of PBMs. They set minimum drug copays, have the pharmacy collect a $15 copay for a $5 drug, and have the pharmacy pay the PMB the $10 difference. They make it a breach of contract for the pharmacy to inform the patient this is happening or to charge the $5 and bypass the insurance. The total lack of anything even approaching ethnics is absurd...
- scarab92 2y agoHow should this system work, in an ideal world?
- Centigonal 2y agoShort answer: Systems 1, 3, 12, or 23 in Figure 3 in this paper are pretty good options: https://eclass.ekdd.gr/esdda/modules/document/file.php/KST_BEID_PDYY120/%CE%9C%CF%80%CE%BF%CF%85%CF%81%CF%83%CE%B1%CE%BD%CE%AF%CE%B4%CE%B7%CF%82%20%CE%A7.%20-%20%CE%A3%CF%85%CF%83%CF%84%CE%AE%CE%BC%CE%B1%CF%84%CE%B1%20%CE%BA%CE%B1%CE%B9%20%CE%A0%CE%BF%CE%BB%CE%B9%CF%84%CE%B9%CE%BA%CE%AD%CF%82%20%CE%A5%CE%B3%CE%B5%CE%AF%CE%B1%CF%82%20%28%CF%83%CF%85%CE%BC%CF%80%CE%BB%CE%B7%CF%81%CF%89%CE%BC%CE%B1%CF%84%CE%B9%CE%BA%CF%8C%20%CF%85%CE%BB%CE%B9%CE%BA%CF%8C%29/Five%20Types%20of%20OECD%20Health%20Systems.pdf https://eclass.ekdd.gr/esdda/modules/document/file.php/KST_B... This is an extremely politicized question in the US, where a public health insurance option (a solution that's popular in much of the rest of the OECD) is fiercely opposed by a large swath of the population. At the very least though, in an ideal world, payers, providers, pharmacies, and PBMs should not be allowed to be part of the same company.
- dave333 2y agoMedicare should spend 1% of its budget each year to buy pharma stocks. Slowly it will become neutral to drug prices since what it pays for expensive drugs will be returned in the stock value.
- the_third_wave 2y agoNo, slowly it will pay out on one side and get back a bit on the other until it becomes a major stock holder and the whole house of cards collapses.
- dave333 2y agoWhy would it collapse? Can limit govt holdings to say 25% of each company to maintain profit motive. I think this would attract other investment - front running the govt money - and greatly increase the ability to research new drugs. Can also direct some research money into drugs with significant benefit but little profit. Over time increased investment would allow lower prices. Over time compounding would help fund medicare.
- the_third_wave 2y agoIt collapses because by the time it is the majority owner the state will pay for it's own "profits".
- Jensson 2y ago> Medicare should spend 1% of its budget each year to buy pharma stocks People would just raise the price for pharma stocks then. Maybe that is a good thing since it would make it harder to buy pharma stocks for others, but the government will still pay too mcuh.
- dave333 2y agoLike quantitative easing raises the whole market? Govt would dollar cost average at least and can spread out buys to avoid front running. Larger market cap with investors holding for the long term helps increase the R&D spend and timeframes.
- onewheeltom 2y agoOur health care system is a profit making enterprise with medical care as a side effect
- bradlys 2y agoIf you’re someone who is interested in these drugs, just know that you can get them from China for 1/10th the cost of what telehealth providers want. I’ve since supplied a few of my friends who have been interested in various peptides and it has been great overall. Some thought it would be a scam or bunk but they’re losing the weight with no side effects. It’s been great.
- Terretta 2y agoFrom the article: You can order GLP-1 peptides from China for cheap. Once you have the peptide, all you have to do is put it in the right amount of bacteriostatic water. In theory this is no harder than any other mix-powder-with-water task. But this time if you do anything wrong, or are insufficiently clean, you can give yourself a horrible infection, or inactivate the drug, or accidentally take 100x too much of the drug and end up with negative weight and float up into the sky and be lost forever. ACX cannot in good conscience recommend this cheap, common, and awesome solution.
- bradlys 2y agoYeah, I just want to be clear that it’s also way cheaper. This is where the compounding pharmacies are often buying from too btw. The price for tirzepatide is under $0.50/mg at this point.
- Clamchop 2y agoWait, people are buying stuff of unknown quality off the internet, mixing it with water in their kitchens, _and injecting it?_ That's wild. Even the article author seems to have a tongue in their cheek when issuing this "warning" that is definitely not a hint. Is it safer than it sounds?
- agsqwe 2y agoIt can be relatively safe with proper handling. There are independent laboratories you can send this "product" to for analysis. Often people organize group buys with some random samples tested.