Wegovy has been dubbed a “big breakthrough” due to its ability to help you lose weight. However, injectable drugs are very expensive and if people cannot afford to continue with it, they experience rebound weight gain that is difficult to stop.
NPR’s Catherine Streeter
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NPR’s Catherine Streeter
Wegovy has been dubbed a “big breakthrough” due to its ability to help you lose weight. However, injectable drugs are very expensive and if people cannot afford to continue with it, they experience rebound weight gain that is difficult to stop.
NPR’s Catherine Streeter
From TikTok influencers to celebrities worried about their “Ozempic face,” drugs like Wegovy and Ozempic are touted as weight loss miracles in a slim-obsessed country.
However, this drug is not intended for cosmetic weight loss. Ozempic is approved for the treatment of diabetes, and Wegovy is for obese people with weight-related conditions that put them at risk for heart disease, such as high blood pressure and high cholesterol. That’s millions of Americans.
And evidence shows that the new class of drugs is far more effective than previous obesity drugs. of New England Journal of Medicine In 2021, the drug was found to lead to an average 15% weight loss.
Demand has soared to such an extent that the FDA database lists the drug’s active ingredient, semaglutide, as “currently in short supply.” Its manufacturer Novo He Nordisk says maintaining a steady supply is a priority. The company also markets his Ozempic to treat diabetes, a low dose of semaglutide.
But at a cost of about $1,400 a month (or out-of-pocket if insurance doesn’t cover it), many people can’t afford to stay on the drug long-term. Also, once people stop taking the drug, there is often rebound weight gain that is difficult to control. I got
That’s what’s happening with Yolanda Hamilton from South Holland, Illinois. Hamilton’s doctor prescribed Wegovy because of her high BMI, high blood pressure, and high blood sugar. She lost her 60 pounds and started feeling better.
“It gave me more energy,” she said, allowing her to exercise and do housework. Her sugar cravings subsided and she felt satisfied eating less.Hamilton “I was very surprised at how much better I felt. The drug is administered at home in weekly injections, which Hamilton says is easy to do.”
Her Aetna insurance plan covered the cost of the drug, but when she changed jobs last fall, her new insurance plan with Blue Cross and Blue Shield of Illinois denied coverage. She currently works in her ER at a hospital that registers patients, which requires her to sit most of her day. And she gained 20 pounds after going off her medication for several months.
“I’m very frustrated with how quickly the weight came back on me,” says Hamilton.
Blue Cross and Blue Shield of Illinois told NPR that benefits offered by employer plans vary. A company spokesperson said, “Depending on a member’s benefit plan, weight loss drugs like Wegovy may be covered. Many other insurers also cover based on what employers are willing to cover. Determine your range.
Barriers to life-changing drugs
The rebound weight gain is not surprising given how the drug works. Wegovy’s active ingredient, semaglutide, contains GLP-1, or glucagon-like peptide, which mimics the GLP-1 satiety hormone in the body. 1. When you eat, GLP-1 is released from your gut and sends signals to brain centers that control appetite.
“This hormone is telling your brain that I’m full and I don’t need to eat anymore,” says Dr. Robert Kushner, of Northwestern University, who is treating Yolanda Hamilton. He also serves on the Medical Advisory Board of , for which he receives an honorarium.
“What the drug companies have done is re-engineer this naturally occurring hormone into a drug,” he explains. That’s what he says.
“I crave sweets,” says Hamilton. And my appetite has increased. I was no longer satisfied with small meals. She’s “losing energy,” she says, as her weight comes back on.
Kushner’s office is helping Hamilton file a denial of insurance, but as she waits, she worries that stopping the medication will affect her blood pressure and blood sugar as well. “She’s at risk of worsening these conditions when she regains weight,” says Kushner.
“When you gain weight, you take more medication,” says Hamilton. Given her long struggle with weight loss, she’s finally found something that works.
Dr. Carla Robinson, a Charlotte, North Carolina-based family physician and medical editor at GoodRx, a company that helps people, said: She finds the lowest prices on generic and branded drugs. There is no generic version of semaglutide.
“Unfortunately, because it’s a new drug, it’s one of the things that manufacturers price it for,” says Robinson.
A representative for Novo Nordisk said the company is offering Wegovy a $500 coupon to cut costs for patients who pay cash.
But this chart from GoodRX shows that the lowest price among all retailers is $1,304 per month.
“Wegovy feels innovative,” says Hamilton. But she says she can’t afford it.
“Some of the people who need it most don’t have access to it,” says Robinson, noting that low-income people experience disproportionately higher rates of obesity.
“We’re talking about a big health equity issue,” she says. Black and Hispanic adults have higher rates of obesity, according to the CDC.
Since Wegovy was approved by the FDA in 2021, some insurance plans have begun covering the drug for people who meet clinical prescribing guidelines. People with at least one “weight-related condition”, such as high cholesterol, or a BMI of 30 or higher, regardless of weight-related condition.
However, insurance coverage is very spotty. Medicare doesn’t cover his Wegovy or other weight loss drugs, and many insurance companies are following Medicare’s lead. There is increasing pressure to change this. As STAT reported last week, Florida’s Moffitt Cancer Center is lobbying for legislation that would allow Medicare to pay for obesity drugs because of the link between obesity and cancer risk. . The NAACP is also registered to lobby on this issue.
Additionally, the American Academy of Pediatrics has created new guidance recommending that pediatricians provide weight-loss medications to adolescents 12 years and older who are obese as an adjunct to behavior change and lifestyle interventions.
long-term unknowns
However, the fact that people may need to keep taking Wegovy indefinitely to maintain weight loss raises concerns about long-term use. “Nausea, diarrhea, constipation, vomiting in some people, or heartburn,” says Kushner.
He says that starting with a low dose and increasing the dose over time can help people become more tolerant to the drug. It’s ongoing and so far this is positive.
However, the drug presents a black box warning because it caused thyroid tumors in rodent studies. Kushner says you need to see if you have a family history of another rare condition called type 2 (MEN 2). “This will be an individual patient conversation,” says Kushner. In general, if you don’t have a history of these conditions, “the drug is considered safe,” he says.
As disturbing as this may sound, it is a reminder that fighting obesity can be dangerous. The theoretical risk of thyroid tumors may be disturbing. But doctors point to the risks of leaving obesity untreated. Heart disease is the leading cause of death in the United States, with obesity and weight-related conditions being the biggest risk factors.
Of course, exercise and dietary changes are still the first strategies to try. However, about 70% of Americans are overweight or obese, and almost half of American adults have hypertension, and one in three Given that these are prediabetes, the group of doctors cite an urgent need for more interventions that may help.
“As a society, we spend $173 billion on obesity-related health care costs,” said Dr. Markus Shabacker, CEO of ECRI, an independent nonprofit that is investigating evidence for new weight-loss drugs. increase.
He argues that the drug could be part of ending the stigma of obesity by treating it like any other medically treated disease. We don’t ask you to just change your diet to get better no, we give you beta blockers, it’s no different here, exercise and diet are key ingredients in tackling obesity, but yes, it’s effective It’s a drug that’s proven to be,” he says.
