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"Outrageously" priced weight-loss drugs could bankrupt US health care

arstechnica.com

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Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#41

Post by paulryanrogers »

operatingthetan wrote: post #24
ajross wrote: post #15

Earlier quoted context omitted.

> Serious question: Why not just bootleg the stuff? Historically, the black market for medication has been vanishingly small. People don't as a rule trust drugs they get off of alibaba or wherever; even the viagra gray market is a small fraction of the prescription revenue. And this doesn't treat something critical, it's a weight loss drug. To be blunt most people would probably choose to remain fat vs. buying an ill…

>To be blunt most people would probably choose to remain fat vs. buying an illegal generic. Wow, I think the exact opposite. Weight loss is a huge industry and people are desperate.

Fentanyl seems to be tainting a lot of black market drugs lately. I'd want to test anything if it came from unofficial sources.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#42

Post by 3abiton »

redwoolf wrote: post #14
loloquwowndueo wrote: post #3

Earlier quoted context omitted.

Patents?

When it comes to pharmaceuticals, the patents are ridiculous. Take for example Contrave[0]. It is a combination of Naltrexone and Bupropion, both of which are no longer under a patent. Put them both in the same pill and it's under a new patent. [0] https://en.wikipedia.org/wiki/Naltrexone/bupropion

So buying them separately and mixing them in your mouth is legal? It's like combining 2 pieces of open-source software and selling them under one product.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#43

Post by swatcoder »

JKCalhoun wrote: post #13
voisin wrote: post #10

Earlier quoted context omitted.

> I'd argue that there's a moral imperative to bootleg the drug and distribute it to those who would benefit from it at a fair price. Why not do away with patents and IP altogether if the standard is that as soon as someone makes something needed it can be stolen?

Why not make an exception for life-saving patents/inventions? The irony that, were it not priced outrageously, it could save the health care industry billions as these people with obesity will otherwise require epesneive treatments if the remain obese.

> it could save the health care industry billions as these people with obesity will otherwise require epesneive treatments if the remain obese.

"Could" is doing a lot of work there. We don't really know what to expect for these patients 20 or 40 years out.

Long-term outcomes and population-scale polypharmacy risks are not really clear, and won't be for decades.

These drugs enable a valuable intervention for individuals at high risk of health hazards and it's fantastic that they're available, but the perspective changes when you look at outcomes for tens (hundreds?) of millions of people over long spans of time -- there are a lot of inescapable unknowns. One can't actually be sure that the benefits of fast, widespread use will outpace the costs, or at what scale.

Many genuinely effective drugs have gone through exactly this kind of hype cycle only to lead to regret, embarassment, and/or skepticism later on.

Good science, and the good public policy that's informed by it, moves slowly.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#44

Post by shawn_w »

redwoolf wrote: post #14
loloquwowndueo wrote: post #3

Earlier quoted context omitted.

Patents?

When it comes to pharmaceuticals, the patents are ridiculous. Take for example Contrave[0]. It is a combination of Naltrexone and Bupropion, both of which are no longer under a patent. Put them both in the same pill and it's under a new patent. [0] https://en.wikipedia.org/wiki/Naltrexone/bupropion

Interesting. I'm pretty familiar with both drugs in the context of addiction treatment and mental health (and seen plenty of people taking both as separate pills), but I've never heard of them indicated for weight loss.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#45

Post by khuey »

mataug wrote: post #39

My hot take on these GLP-1 drugs is that they won't work long term for most people. If the plan is to give the drug to as many obese people as possible and take a victory lap, thats going to fail. I don't think its resonable for most people to continue taking GLP-1 antagonists all their lives. Its been widely shown that most people rapdily gain back ~2/3 of their weight after stopping semaglutide. This means that the…

> I don't think its resonable for people to continue taking GLP-1 antagonists all their lives.

Why not? People take statins or beta blockers for the rest of their lives. Sure it's not that feasible at current US prices but they won't be that expensive forever.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#46

Post by RcouF1uZ4gsC »

> If Novo Nordisk set its US prices for Wegovy to match the Danish price, spending to treat half of US adults with obesity would drop from $411 billion to $94.5 billion, a roughly $316.5 billion savings.

The solution to the drug price crisis is for the US to stop subsidizing the rest of the developed world.

The US should set a rule saying that it will not pay more than the price the drug company charges to any developed country.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#47

Post by epylar »

mataug wrote: post #39

My hot take on these GLP-1 drugs is that they won't work long term for most people. If the plan is to give the drug to as many obese people as possible and take a victory lap, thats going to fail. I don't think its resonable for most people to continue taking GLP-1 antagonists all their lives. Its been widely shown that most people rapdily gain back ~2/3 of their weight after stopping semaglutide. This means that the…

> I don't think its resonable for people to continue taking GLP-1 antagonists all their lives.

But why? Plenty of chronic conditions require chronic medication (e.g. insulin).

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#48

Post by ano-ther »

A_D_E_P_T wrote: post #2

> A study by researchers at Yale estimated that drugs like Wegovy can be profitably manufactured for less than $5 per month. Serious question: Why not just bootleg the stuff? It's a very small protein, easy to make, and "research chemical" companies that sell structurally similar bodybuilding drugs and nootropics are a dime a dozen. Search online for "BPC-157" (a protein drug of only slightly inferior complexity) and…

They have patent protection and the US government goes to great lengths to defend intellectual property rights.

Technically, compulsory licensing is allowed under TRIPS (https://www.wto.org/english/tratop_e/trips_e/public_health_f...). But the US and others opted out of this (https://www.wto.org/english/docs_e/legal_e/31bis_trips_annex...).

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#49

Post by willio58 »

mataug wrote: post #39

My hot take on these GLP-1 drugs is that they won't work long term for most people. If the plan is to give the drug to as many obese people as possible and take a victory lap, thats going to fail. I don't think its resonable for most people to continue taking GLP-1 antagonists all their lives. Its been widely shown that most people rapdily gain back ~2/3 of their weight after stopping semaglutide. This means that the…

While I 100% agree that GLP-1 antagonists won’t lead most to making actual changes to their behaviors with food outside of forcing them to not over-eat when actively taking the drug, I am not so sure about your hot take here.

A woman I know has been on this stuff for a couple years now and while she has plateaued for about 6 months, her current weight is now in a healthier spot.

It’s crazy what losing some weight can do to people’s mental health too. Like her home is more organized, she’s more active with walking (doesn’t hurt anymore), she just overall describes not fearing food anymore.

And now for the bad news, her insurance no longer covers it. It’s kind of insane but apparently this stuff has a black market, like she buys it from one of her coworkers like it’s some sort of street drug.

In summary I think we need more time to see but from what I’ve heard this does seem to be a long-term solution similar to insulin shots if you had to compare to something existing.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#50

Post by khuey »

jlund-molfese wrote: post #30
tempsy wrote: post #21

This is silly because it doesn't take into consideration all the health issues that are alleviated when people stop overeating and get down to a normal weight

Which ones weren’t accounted for in the CBO report, which tried to take into consideration other health issues (from a financial perspective at least)? It states that “at their current prices, [anti-obesity medicines] would cost the federal government more than it would save from reducing other health care spending—which would lead to an overall increase in the deficit over the next 10 years”

I know 10 years is the standard CBO timeframe but are we sure it's the correct one for a drug like this?

If you gave a vaccine 100% effective against cancer to 18 year olds it would probably look like a money loser on a 10 year timeframe but that's clearly not the window to measure.

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