The Gilded Age
Now that Novo Nordisk and Eli Lilly have developed safe medications that help people lose weight, it’s the beginning of a golden age.
Fired by celebrity acclaim and third-party advertising, demand for Ozempic, Mounjaro and Wegovy is already outstripping availability. A new drug, Zepbound, is about to hit the market any day now. And prices of about $1,000 for a month’s supply aren’t discouraging users from paying right out of their own wallets for medications that insurers still hesitate to cover.
The writing on the wall is plain: Obesity is a disease and treating it saves lives. At some point soon, US insurers will have to cover weight-loss medications, further opening the gates to utilization.
That’s when we may begin seeing the real impact of the drugs on the long list of conditions that are often associated with obesity, like diabetes, heart attacks, strokes and kidney disease.
But so far, it appears that many of those who might need these drugs most aren’t getting them. Analytics firm Trilliant Health took a look at utilization patterns of GLP-1 drugs in New York and found that the highest levels were in the ritzy Upper East Side.
The district “has one of the highest life expectancies and the lowest rates of diabetes and obesity in New York City,” Trilliant said in a September report. “In East New York, which has one of the highest obesity rates in New York City, GLP-1 prescribing rates are lower than more affluent neighborhoods.” Broader insurance coverage promises to smooth out some of those inequalities. Still, plans with high out-of-pocket costs may put the medications out of some US patients’ reach.
Just as much as GLP-1s, statin drugs like Pfizer’s Lipitor were revolutionary in their time, lowering the risk of heart disease and death in large studies. Fittingly — and just as GLP-1s will be soon — they were widely covered by insurers.
Yet use of each of the major statin drugs soared after they became available in cheaper generic forms. As of 2019, some 92 million Americans took statins as prescribing guidelines expanded, according to one study.
Obesity is widespread across the US regardless of income levels. But it’s most prevalent among those who are poor, and often have worse access to healthy food and preventative health care, as well as less time for things like exercise. This population needs access to obesity drugs, and needs it before their golden age is over. — John Lauerman
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