“But the study wasn’t able to distinguish if people involved lost weight intentionally or unintentionally, Hussain added. ”
No questions were asked about changes in activity level and diet quality between the baseline study visit and subsequent study visits, so we do not have any information on how those factors may have impacted the results,” Haperin said. ”
Good point about unexplained weight loss, but it seems they didn’t differentiate. Pretty big study flaw, it seems. Sounds like it was purely correlational.
If about a third of US adults are obese, and if every obese adult in the US takes semaglutide or a similar drug for weight loss, and the cost is about $1k per month or $12k per year, that would increase the overall average cost of health care by $4k (from $13k to $17k) per US adult.
But then the question is, would that reduce other health care costs by $4k per US adult, due to reduction of health problems due to less obesity?
Of course, insurance companies and employers may still balk at paying the costs, since the cost of semaglutide and similar drugs is an up front cost, while any savings from reduced obesity-related health problems is likely to come somewhat later, perhaps when the covered person is under some other health insurance plan or Medicare.
Good points. But don’t insurance companies pay for smoking cessation programs and meds like bupropion (yes, now this generic is available and cheaper) to help with smoking cessation to avoid the long term costs? Ditto with alcohol cessation programs.
If the market truly becomes that large a proportion of the population (or even say half of obese people), then costs will come down, either because of new competition (eg from generic drugs in the same class), or through more direct government action (price controls).
Since many health insurance plans are paid for mostly by employers, employers have some choice as to what things to cover for the plan that they contract. Employers may choose to cover smoking and alcohol cessation programs because (a) they do not cost as much as semaglutide, and (b) there are immediate benefits to the employer when someone stops smoking or drinking (fewer smoke breaks, less complaining about secondhand smoke, fewer employees coming to work hung over, etc.).
Because this class of drugs is new, it will be a while before the patents run out and allow generic versions to be sold. Price controls, or even having Medicare negotiate prices for drugs, has significant political and lobbying opposition.
Alcohol treatment programs can be $$$. if a patient needs detox and then an inpatient ot IOP stay, its $$
But are they $$$ permanently for the given patient, like semaglutide is expected to be?
It will also be a while before take-up grows. Only a tiny proportion of obese people can afford the current price/co-pay. So take-up is self-limiting for the moment. I’m not sure how you think we get to a third of the population taking it and the price staying the same unless some government coverage mandate is involved?
Yes, if employers largely decide to drop coverage of drugs used for weight loss, that could limit use to those who can self-pay. But then that can also affect those using Ozempic for diabetes (if coverage is dropped for all forms of semaglutide, or if coverage is dropped only for Wegovy and people using it get their physicians to prescribe Ozempic off-label, causing shortages).
Yes unfortunately the relapse rate is high, and retreatment is common. And while many successful recovering alcoholics do well with maintenance using AA support groups, many also need ongoing psychiatric/therapeutic care. This costs $
My friend’s husband is on this.
He retired a few years ago from a very stressful job. Immediately started exercising, eating better, etc, and lost a bunch of weight. Looked great and felt great. Then he came out of retirement and took on an even more stressful job. He has gained all of his weight and then some back. He is the largest I ever recall seeing him. He is tall, but I am guessing he would be categorized as obese. The idea was this would be a, “substitute,” for him since he no longer has the time to exercise and can’t seem to help himself from stress eating crap when he is working.
So, he has proven that he can lose weight and maintain weight loss on his own. With that in mind, this doesn’t seem like a good use of this substance to me. He is having knee surgery in December, and I guess his ortho would like him to lose weight, but I know the ortho did not suggest this. He is using something mixed by a different doc, but he is not using Ozempic.
At my last physical, I was noted as being normal weight and “athletic in appearance”. I was curious what one of the facebook posts I’m bombarded with would say. I have a Noom account and put my stats in and learned that I qualified for their medication assisted weight loss program, but there was no provider in my area. I then put my stats into “Found” and again, I qualified for their program. Neither my cardiologist or my gp has suggested weight loss to me and they have not been shy about doing so in the past.
As I explored a bit further, it seems most Found users are not receiving Ozempic or Wegovy as the first line medication. One user is taking a combination of naltrexone and bupropion to control what seemed to be a binge eating disorder. Within Noom, many users are using Mounjaro.
Ozempic and Mounjaro are both GLP-1 drugs. However, Ozempic is FDA approved to reduce the risk of major cardiovascular events in individuals with Type II diabetes and established cardiovascular disease. Mounjaro appears more effective in controlling blood sugar. Is a provider seeing you for the sole purpose of prescribing weight loss medication going to know which medication is the best for you?
People are overweight for many, many reasons and that can lead to any number of medical conditions. I just want to see appropriate medical care and supervision of anyone who is using these drugs. When people were so suspicious of the Covid vaccines, why are they so immediately accepting of these drugs?
But is the percentage of adults in the US who use the longer term versions of alcohol use disorder treatment anywhere near the percentage of adults in the US who are obese?
Good question. Don’t know the numbers. But there are a lot of alcoholics. That’s when during the pandemic they did not close liquor stores. They didn’t want space in the hospitals taken up by people going into DT’s/withdrawal. Also, for both obesity and alcoholism often it is the secondary medical
Complications ( liver problems, ascites, kidney, pancreas damage, esophageal bleeds, etc.)
And a quick google search said that 6% of the US population has an alcohol abuse problem.
Is there some correlation between those two groups?
Ozempic started clinical trials 8 years ago and was approved for those with type II diabetes 6 years ago.
But how many of them need long term expensive treatment? In any case, that is far less than the one third who are obese and therefore potential users of semaglutide or similar drugs.
And alcoholism has other secondary issues like increased absenteeism, auto accidents, etc. There was, IIRC, a bus driver not long ago who was drinking and taking a bus load of kids to school and had a severe accident. That must have cost the school $$$
