What to know about tirzepatide and similar weight loss

The retail price of liraglutide (Saxenda) and semaglutide (Wegovy) injection pens is $1,700 per month for uninsured patients in the United States. That’s a little over $20,000 a year.

The type 2 diabetes formulations of these drugs have high prices, even though they are much cheaper. Ozempic (a version of semaglutide for people with type 2 diabetes) and Mounjaro (brand name tirzepatide) retail for about $1,100, or about $600 less per month.

With Johnson’s insurance, his payments were $50 a month. He covers half of this with a manufacturer-issued savings card.

“I’m very fortunate to have good insurance and also the finances to cover a co-pay if needed,” she said.

Some insurance companies do not cover certain GLP-1 agonists. For example, Medicare and most insurance companies do not cover Wegovy, according to GoodRx. Called Calibrate, the app offers personalized coaching and access to prescription GLP-1 agonists for $1,649 a year or $138 a month. That’s in addition to drug prices, but Calibrate claims to work with users’ insurance companies, according to its website. It also guarantees weight loss of 10% or more. (Calibrate did not respond to a request for comment at the time of publication.)

Despite the price, Wegovy’s new prescriptions have been suspended. Novo Nordisk, the maker of Wegovy and Ozempic, was forced to change its production schedule due to a shortage of needles used to deliver the drug from a third-party vendor. To continue serving patients taking Wegovy, Novo Nordisk is currently only releasing the two highest doses, 1.7 mg and 2.4 mg, and the company said it hopes to meet growing demand for Wegovy by the second half. of 2022.

Because of the Wegovy shortage and Ozempic’s relatively low price, some patients have sought over-the-counter prescriptions for type 2 diabetes from their doctors. However, Dr. Jason Brett, Novo Nordisk’s executive director of diabetes and obesity medical affairs, argues that healthcare providers should not interchange the drugs.

“The active pharmaceutical ingredient is the same, semaglutide, but they have different doses, different dosing schedules, and they have different devices,” he said.

It is not clear whether they should be taken indefinitely for weight loss

While Johnson was taking Saxenda, she was able to manage her diet better, without feeling hungry all the time. But then his weight began to plateau. Even when she was on the highest dose of the drug, her appetite returned and she stopped injecting herself every week. He soon returned to his peak weight.

“Once I stopped taking it, I stopped doing a lot of the things I should have been doing, like watching my food and weighing myself regularly. Within a few weeks I was back to full strength,” he said. “If you don’t change your behavior, it’s just a short-term fix, right?”

He is trying the next Wegovy. However, due to the lack of low-dose versions of the drug, nausea can occur as a side effect. Her doctor prescribed anti-nausea medication and she noted that “there aren’t many options.”

Wharton believes that these drugs allow people to make healthy lifestyle changes, but as with other chronic conditions of the mind or body, people with obesity-related health problems may always need some form of treatment.

“The medicine does not dissolve fat. All of this allows you to change your behavior,” Wharton said. “But because we know it’s a chronic medical-biological condition, patients can never come off the drug like they do with other drugs for other chronic conditions.”

Wharton also believes that the idea that people can or should be off drugs is actually counterintuitive and harmful.

“It’s about teaching a schizophrenic person not to hear voices,” he said. “But of course, if you have a schizophrenic patient and you take them off their medication, what happens? The voices will come back.’

Duke has a different perspective. He believes that even if patients with obesity and/or prediabetes can take liraglutide and semaglutide, that doesn’t mean they need a lifelong prescription.

“I’m not advocating keeping people on medication they don’t need,” he said. “If someone can maintain their weight loss because they learn how to manage their diet, how to exercise, how to help their body reprogram its insulin sensitivity response, I love to see it. I would at least like to see patients be able to reduce the dose or stop altogether in the future.”

When someone on an anti-obesity drug decides she’s ready to get pregnant, Duke lowers their dose.

“This is important because they cannot continue this medication during pregnancy,” she said. Wegovy should be discontinued at least two months before a planned pregnancy, for both male and female patients, due to the risk of harm to the fetus, according to the prescribing information. For Ozempic, an antidiabetic formulation of the same molecule, the FDA says it can only be used during pregnancy if the potential benefits outweigh the potential risks of fetal abnormalities and miscarriage. (High blood sugar due to diabetes also increases the risk of birth defects, stillbirth, and pregnancy complications, and insulin is considered the safest drug to reduce this risk.)

“I had a patient who was on one of these drugs for the main part of the pandemic. We left the service when they were ready to start a family, and when their pregnancy test came back positive, they went off the medication.

They are not for people with short-term weight loss goals

If you’ve been buzzing around these drugs and wondering if this new class of drug might be the answer to your short-term plan to shed a few pounds before your upcoming wedding, experts say these drugs aren’t for you.

Anti-obesity drugs are not for those who can change their behavior on their own, Wharton said.

“If someone wants to lose 10 pounds, they can do it by changing their behavior. They may exercise more or eat better. “If you need to lose 10 kilograms, I will not talk to you,” he said. “But dealing with chronic obesity is a neuroscience problem, not a behavioral science one, as everyone would like it to be.”

Just as Johnson’s relief from taking liraglutide provided more insight into his persistent hunger, the GLP-1 treatment is giving the medical community insight into how obesity works. Wharton hopes the advent of these drugs will help doctors destigmatize chronic obesity, clarifying that it is a treatable health issue rather than a character flaw.

“The fact that these drugs work inside the brain, where the disease resides, makes it even more clear that there’s a biological connection to it,” Wharton said. “The more we believe that it’s a biological medical condition, and the more we understand that because drugs work, the more we can understand that it’s not the person’s fault.”

Leave a Comment

Your email address will not be published.