Dec 12, 2022 - Health

The growing market for weight loss drugs

Illustration of a measuring tape around a pill bottle.

Illustration: Shoshana Gordon/Axios

A new generation of FDA-approved diabetes drugs that can also help patients lose weight is prompting demand so strong that it's led to shortages.

Why it matters: At least 1 in 3 American adults meets the definition of obese, which can bring an increased risk of heart disease, diabetes, and certain cancers, per the CDC. The condition is estimated to cost the U.S. health care system nearly $173 billion a year.

What they're saying: "We now have a breakthrough class of drugs that can achieve profound weight loss equivalent to bariatric surgery," Eric Topol, executive vice president of Scripps Research wrote in a blog last week. "That, in itself, is remarkable. Revolutionary."

State of play: There are a handful of drugs that have come on the market in recent years that have far outpaced previous generations of weight loss drugs in effectiveness.

  • These include semaglutide, which is sold by Novo Nordisk under the brand names Ozempic and Wegovy, as well as liraglutide, also sold by Novo. There's also a drug known as tirzepatide, sold by Eli Lilly under the brand name Mounjaro.
  • These are largely part of a growing class of drugs known as glucagon-like peptide-1, or GLP-1, agonists which are hormones that can increase insulin sensitivity, delay gastric emptying and increase satiety.
  • The GLP-1 market is fast-growing, with global sales of all obesity drugs expected to total $30 billion by 2030, according to analysts at Cowen Inc. Novo Nordisk is projected to capture the largest share with Wegovy sales topping $7 billion.
  • There are also more drugs in the pipeline. Last week, Amgen reported promising results from an early-stage clincial trial of yet another weight loss drug candidate.
  • But insurers have resisted paying for weight-loss drugs — for example, balking at Wegovy's $1,300-a-month cost. The presumption is obesity is behavioral, despite evidence it can be linked to hormonal factors and insulin resistance, per NBC News.

The big picture: But fueled in part by stories of celebrities snapping up doses of drugs like Ozempic at hundreds of dollars a pop, individuals around the country have been clamoring for their own doses, making the drugs increasingly hard to find for those who need it most.

  • "The demand exceeded the expectations any of these drug manufacturers could've imagined," Amanda Velazquez, who works at Cedars-Sinai Center for Weight Management and Metabolic Health in Los Angeles, told CBS News.

Between the lines: There are potential concerns associated with these drugs.

  • They carry gastrointestinal side effects, can cause low blood sugar and have a possible association with an increased risk of pancreatitis and some cancers, according to Mayo Clinic.
  • And it's still unclear if insurers will pay for them. Currently, much of the coverage is limited to those with diabetes. Most of the treatments can cost upwards of $1,000 a month or more out of pocket.
  • "The cost of these drugs will clearly and profoundly exacerbate inequities since they are eminently affordable by the rich, but the need is extreme among the indigent," Topol wrote.

The bottom line: More effective solutions in the fight against obesity may finally be arriving. But so far, their costs mean we won't see their true impact among those who most need them in the near term until insurers are able to work out their value proposition for the long term.

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