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Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

independent.co.uk

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Re: Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

#231

Post by bedast »

somehnguy wrote: post #218
bedast wrote: post #73

Earlier quoted context omitted.

It's weird for anyone to "feel abandoned by Big Pharma" when you abused a coupon to get a drug for off-label use, and terms were changed to match its on-label use. Especially when there's versions of these drugs with on-label use for weight loss.

Why should anyone need to use a coupon in the first place? Just charge a reasonable price, don’t make people jump through hoops for medicine.

Brand new drugs tend to take a while to get on insurance formularies. I believe Mounjaro is still missing in most formularies. Lilly wants people on their drug, not the competition.

Re: Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

#232

Post by bedast »

fakedang wrote: post #223
agsqwe wrote: post #195

Earlier quoted context omitted.

I think what's meant here it's that the manufacturer chose to target specific patient groups (T2D) and commercial insurances to get the highest profit per dose. About 40% of adults in the US are obese, they could have made the drug available at much lower cost and get their profits from economies of scale. Instead, the production is low and the focus is narrow.

It's not always the case that production is made intentionally low. There are actual limits to how much times a chemical/biochemical production process can be run in a given year. I'm actually learning this the hard way with one biotech project. The alternative might be a $200 million dollar production facility which may not even be feasible to cater to the excess of consumers. Or which may be too excessive for the e…

They also probably don't want to put significant investment in boosting production knowing that will be temporary since the weight loss effects aren't permanent. As someone who has been on GLP-1 RA for a decade, starting with Victoza, and now on Mounjaro, those weight loss benefits have no effect on me anymore. Delayed gastric emptying and appetite suppression is so far reduced that it might as well not be a thing anymore. But I don't use this drug for weight loss, I take it for glycemic management, and it still works great for that. I have to do the work to continue my weight loss and maintenance.

Yeah, these drugs aren't new but the wide world is just learning about the weight loss aspect. So they don't know this is a temporary solution.

Re: Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

#233

Post by bedast »

anaisbetts wrote: post #204
bedast wrote: post #36

Mounjaro is not an obesity drug. It's a type 2 diabetes drug. Do not call it an obesity drug. The headline is editorialized. The linked article's headline: The ‘next Ozempic’ became a social media sensation. Then everything changed The coupon didn't go away. The coupon's terms changed. I'm using the coupon now. Because I have type 2 diabetes. The coupon changed because people were using it to get the drug for off-lab…

> Leave the diabetes drugs alone. Is artificially partitioning what is almost certainly the same medication (with the same manufacturing process) into two separate product lines actually a Good Thing? This means that when Mounjaro has supply problems even with the split, diabetics won't be able to get it because part of the supply is inaccessible to them since it is dedicated to a different "product". Instead we shou…

Significantly increasing production for a temporary benefit is going to require significant investment. Since it is a temporary benefit, it's probably not worth that significant investment. Because eventually the demand will falter.

And yeah, the weight loss benefit is a temporary benefit. It may last a few years, but it fades. This is not a new drug class. The weight loss aspect to it is also not new (Saxenda, the weight loss variant of Victoza, released in 2014). Liraglutide was in trials for weight management when I started Victoza. That was a decade ago. I'm on Mounjaro now for glycemic management and it works great for that. But it's not doing anything for appetite, delayed gastric emptying, etc.

Re: Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

#234

Post by bedast »

serf wrote: post #161
bedast wrote: post #91

Earlier quoted context omitted.

I care that many people I know are losing glycemic control because they're going on a waiting list for their medication while Kim K and Elon Musk and TikTok promote easy mode cosmetic weight loss.

if someone is 'losing glycemic control' because they can't get a specific new en-vogue med, then their doctor is doing a poor job. there is a very big problem with blaming the suffering who find relief with this drug -- regardless of what their ailment is -- rather than blaming the systems and processes that lead to a supposed shortage that urged a price adjustment. forgive me for diving into conspiracy for a second…

You are among the people just learning about this class of drug. It's been around since 2004 (Byetta). I've been taking it since 2012 (Victoza). Even then, it was known to promote weight loss (Saxenda approved around 2014).

This is not a new hotness. And many diabetics have used this drug class for a long time.

And yeah, you're jumping into conspiracy theory. Ramping up production would likely take significant investment. Do they have the resources? Probably. But given the weight loss benefit is temporary (seriously, it is, ask anyone who has used one of these drugs for a significant amount of time), do you think they're going to sink significant investment into production when demand is going to wane in a few years? Well, you see, their investors are going to say no, and they hold the final say.

Re: Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

#235

Post by bedast »

Animats wrote: post #214
bedast wrote: post #36

Mounjaro is not an obesity drug. It's a type 2 diabetes drug. Do not call it an obesity drug. The headline is editorialized. The linked article's headline: The ‘next Ozempic’ became a social media sensation. Then everything changed The coupon didn't go away. The coupon's terms changed. I'm using the coupon now. Because I have type 2 diabetes. The coupon changed because people were using it to get the drug for off-lab…

> Mounjaro is not an obesity drug. It's a type 2 diabetes drug. Do not call it an obesity drug. It's in round 2 of phase 3 clinical testing as an obesity drug, and will probably have full approval this summer.

Tirzepatide is in testing. The weight loss variant will not be called Mounjaro. If they follow similar patterns from Novo Nordisk with Saxenda and Wegovy, dosing will be different for the weight loss variant, which means it won't carry the same label.

Re: Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

#236

Post by bedast »

mise_en_place wrote: post #157
bedast wrote: post #36

Mounjaro is not an obesity drug. It's a type 2 diabetes drug. Do not call it an obesity drug. The headline is editorialized. The linked article's headline: The ‘next Ozempic’ became a social media sensation. Then everything changed The coupon didn't go away. The coupon's terms changed. I'm using the coupon now. Because I have type 2 diabetes. The coupon changed because people were using it to get the drug for off-lab…

I feel like you're splitting hairs. The intended purpose of GLP-1 drugs is to improve A1C in existing diabetic patients. Weight loss is directly correlated with that, because if your body is properly expending glucose, then the excess will not be stored as fat, or sit around in your blood stream in the case of diabetics.

Do you even know what A1c is? Or how GLP-1 RA achieves this goal?

GLP-1 RA does NOT achieve a reduced A1c through weight loss. It achieves improved glycemic control by slowing the release of glucose into the blood as well as promoting increased production of insulin in response to glucose. The overall result is a reduction in blood glucose.

A1c is a measure of your glycemic health that spans around 90 days with heavier weight on more recent trends. It's like a longer blood glucose average measurement. There are actually algorithms that can calculate an estimate of your A1c based on blood glucose trends, which is referred to GMI (glucose management indicator).

The gastric effects leading to feeling full sooner and longer are a side effect and is what leads to weight loss. It also fades with time. Having been on various GLP-1 RAs over a decade, they don't provide this benefit to me anymore. Even with Mounjaro also being a GIP, it's just doing its primary job for me.

Re: Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

#237

Post by unmole »

Dove wrote: post #187
HyperSane wrote: post #178

Earlier quoted context omitted.

All obesity is fundamentally caused by eating too much because fat contains energy that HAS to come from food.

Well, blood sugar contains energy that has to come from somewhere, too, but one would hardly say this means type 2 diabetes is fundamentally caused by eating too much. Shoot, tumors contain energy that has to come from somewhere... Of course, you could rightly reply that there are a lot of complicated things that happen between the food and the problem, and while those diseases require an energy surplus, that neither…

> but one would hardly say this means type 2 diabetes is fundamentally caused by eating too much.

Eating too much is literally what causes type 2 diabetes.

Re: Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

#238

Post by somehnguy »

bedast wrote: post #231
somehnguy wrote: post #218

Earlier quoted context omitted.

Why should anyone need to use a coupon in the first place? Just charge a reasonable price, don’t make people jump through hoops for medicine.

Brand new drugs tend to take a while to get on insurance formularies. I believe Mounjaro is still missing in most formularies. Lilly wants people on their drug, not the competition.

So just yet another case of the American healthcare/insurance system being absolutely bottom tier in usability, profits for middlemen over all else.

Re: Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

#239

Post by bedast »

somehnguy wrote: post #238
bedast wrote: post #231

Earlier quoted context omitted.

Brand new drugs tend to take a while to get on insurance formularies. I believe Mounjaro is still missing in most formularies. Lilly wants people on their drug, not the competition.

So just yet another case of the American healthcare/insurance system being absolutely bottom tier in usability, profits for middlemen over all else.

This is not only an American issue. I've seen people in the UK struggle to get access to treatments and devices through the NHS. Canada tends to follow what the US is doing even though they have their more socialized system. It all tends to be a bit of a mess with brand new drugs and devices. And Mounjaro is new as of last year (approval less than a year ago?).

Re: Diabetes drug Mounjaro was available at $25/month, then increased to $1k/month

#240

Post by anaisbetts »

MichaelZuo wrote: post #229
anaisbetts wrote: post #204

Earlier quoted context omitted.

> Leave the diabetes drugs alone. Is artificially partitioning what is almost certainly the same medication (with the same manufacturing process) into two separate product lines actually a Good Thing? This means that when Mounjaro has supply problems even with the split, diabetics won't be able to get it because part of the supply is inaccessible to them since it is dedicated to a different "product". Instead we shou…

Who is this 'we'? I'm quite certain a large fraction of the HN userbase still believes that people can do independent business without being forced along one direction or another.

What in the world are you talking about
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