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Can 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 a

Can 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 ago
Knowing 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 ago
  The 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 ago
  I'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 ago
  Well, 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 ago
Few 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 ago
  Rybelsus doesn’t work.
  - oatmeal_croc 2y ago
    Of course it does, it is just much less effective than the injectable versions.
- alabastervlog 2y ago
  Further, 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 ago
They 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 ago
Americans 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 ago
  It'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 ago
Most 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 ago
I 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 ago
  Or 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 ago
    I 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 ago
    Deliberately 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 ago
1) 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 ago
    I think that’s a pretty average income for a couple with two children
    - jwiz 2y ago
      Median household income is like $80k
    - novemp 2y ago
      In San Francisco, maybe.
      - disgruntledphd2 2y ago
        Yeah 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 ago
People 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 ago
  There 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 ago
    Theoretically, 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 ago
  It 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 ago
    The sellers can write it off as a loss. It’s a way to avoid paying taxes
    - nazcan 2y ago
      What 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 ago
        I 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.
    - deleted 2y ago
fragmede 2y ago
Say 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.

noduerme 2y ago

Knowing 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 ago
The 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 ago
I'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 ago
Well, 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 ago

Few 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 ago
Rybelsus doesn’t work.
- oatmeal_croc 2y ago
  Of course it does, it is just much less effective than the injectable versions.
alabastervlog 2y ago
Further, 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 ago

They 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 ago

Americans 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 ago
It'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 ago

Most 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 ago

I 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 ago
Or 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 ago
  I 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 ago
  Deliberately 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 ago

1) 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 ago
  I think that’s a pretty average income for a couple with two children
  - jwiz 2y ago
    Median household income is like $80k
  - novemp 2y ago
    In San Francisco, maybe.
    - disgruntledphd2 2y ago
      Yeah 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 ago

People 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 ago
There 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 ago
  Theoretically, 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 ago
It 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 ago
  The sellers can write it off as a loss. It’s a way to avoid paying taxes
  - nazcan 2y ago
    What 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 ago
      I 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.
  - deleted 2y ago

fragmede 2y ago

Say 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.