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Millions of Americans need drugs like Ozempic. Will it bankrupt the health care system?

Karen Kaplan, Los Angeles Times on

Published in News & Features

An April 24 letter from Vermont Sen. Bernie Sanders to the CEO of Novo Nordisk began with heartfelt thanks to the Danish drugmaker for inventing Ozempic and Wegovy, two medications poised to improve the health of tens of millions of Americans with obesity and related diseases.

But the senator's grateful tone faded rapidly.

"As important as these drugs are, they will not do any good for the millions of patients who cannot afford them," Sanders wrote. "Further, if the prices for these products are not substantially reduced they also have the potential to bankrupt Medicare, Medicaid, and our entire health care system."

It's a sentiment that comes up regularly among people who are huge fans of the medications and their close relatives, Eli Lilly's Mounjaro and Zepbound. All of them work by masquerading as a natural hormone called GLP-1 and tricking the body into slowing digestion and reducing blood sugar.

The medications help patients lose double-digit percentages of their body weight and keep it off — an average of 12.4% in the clinical trial for Wegovy, and an average of 18% at the highest dose in the trial for Zepound. It's rare for insurance companies to cover GLP-1 drugs for weight loss alone, and Medicare is forbidden by law from doing so. But as the pounds fall, so do the risks of serious problems like type 2 diabetes, hypertension, heart attacks and strokes, and the medications can be covered to prevent these conditions.

"Obesity is a huge public health crisis, and for so long we had no treatments that really made a difference," said Dr. Lauren Eberly, a cardiologist and health services researcher at the University of Pennsylvania. "These medicines could change the trajectory of your disease and save your life."

 

That makes these drugs extremely valuable. Unfortunately, they're also extremely expensive.

The sticker price for Ozempic, which the Food and Drug Administration approved to treat type 2 diabetes, is more than $12,600 per year. Wegovy, a higher-dose version approved for weight loss in people with obesity and as a way for overweight patients with cardiovascular disease to reduce their risk of heart attack and stroke, retails for nearly $17,600 a year.

Mounjaro and Zepbound mimic GLP-1 as well as a related hormone called glucose-dependent insulinotropic peptide, or GIP. Their list prices add up to roughly $13,900 per year for Mounjaro, which is approved as a diabetes treatment, and about $13,800 per year for Zepbound, the weight-loss version.

Eberly said those prices are simply too high.

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©2024 Los Angeles Times. Visit at latimes.com. Distributed by Tribune Content Agency, LLC.

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