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When the US Food and Drug Administration approved a promising new anti-obesity drug last month for sale in the United States, it was the first such treatment to be approved since 2014.
In clinical trials, weekly injections of semaglutide or Wegovy as indicated – helped people lose an average of 15% of their body weight. That’s an average of about 34 pounds in 16 months before they gain weight. Approximately triples what is achieved with other drugs on the market. At the very least, Wegovy has not raised any of the alarm signs for FDA or obesity doctors that it can cause serious side effects for some people who have tried fen-fen or other obesity treatments.
But with Wegovy’s monthly price of $ 1,000 to $ 1,500, one big question remains. Will insurers cover its significant costs for millions, such as the benefited Marleen Greenleaf?
Greenleaf grew up on the island of Trinidad, where his family paid little attention to what he ate and paid a high medical price, he says. “My husband has diabetes, my sister has diabetes, my brother has diabetes.”
Since then, he has tried many failed diets, says Greenleaf, now 58, an administrator at the Washington Conservatory. Then in 2018. He registered for a clinical trial of a new drug once a week. a shot that changes the way his brain signals hunger.
A medicine that finally stops his cravings
He noticed the change right after his first Wegovy injection. “There was something about my brain that told me I was not hungry,” he said. No more craving for the chocolate chips he adores. Without cravings, he was able to slow down and review the foods he wanted to get.
“I also wanted to eat healthier,” he says. “I was looking at options, I was reading labels, I was looking at calories. Not just calories, but sugar. ”
During a 68-week research experiment, Greenleaf lost 40 pounds. Her blood pressure dropped, which meant she had the right to donate a kidney to her husband on dialysis.
“It was one of the best gifts of life I could ever give,” she says.
But after that study, Greenliffe regained some of his weight. Wegovy is considered a long-lasting, possibly lifelong drug for the treatment of chronic obesity. In pre-marketing clinical trials, weight loss averaged 15% to 18%, even while people were still on medication. And as in the case of Greenleaf, once they stopped injecting weekly, some of that weight returned.
Now Greenleaf wants to restart Wegovy.
“My only challenge is to actually get an insurance company,” he says.
The price of Ob contraceptives is very low
It turns out that insurance coverage is a huge issue. Not just for Wegovy, but for obesity drugs in general. Some private insurers actually include some anti-obesity drugs in their list of covered drugs. It is too early to say whether Wegovy will compile these lists. Many doctors and patients are optimistic because it is a larger dose of existing diabetes called osperm that is often covered by insurers.
Several selected state-owned Medicaid programs will include medications to treat obesity in some circumstances. But, essentially, Medicare does not cover anti-obesity drugs; many private insurers usually follow Medicare’s example.
But there is a need for good treatment, says Dr. Fatima Cody Stanford, a leading Harvard obesity researcher. He was not involved in Wegovy clinical trials, but was closely monitoring them. “I’m excited about it,” she says, because of the sudden weight loss.
The drug works on the brain, so people eat less and keep less than what they eat. It helps to deal with excess weight, as it helps with, for example, liver or heart disease.
Why is the FDA slowly approving obesity treatment?
There is a long history of drugs that seem to be promising treatments for obesity but are unsuccessful. Amphetamines were prescribed decades ago until their addictive properties were discovered. The combination of fenfluramine և phentermine, commonly known as the fen-phen diet drug, was widely marketed in the 1990s, and was later phased out for heart valve problems.
These experiments և other results doctors were skeptical about.
“In the field of ob obesity medicine we have learned to be carefully Every time we are optimistic about having a new medicine, which seems promising.
So far, Eneli sees no obvious concerns about the class of drugs that Wegovy includes, he calls the results so far. “Very promising.” Wegovy is similar to another drug made by Novo Nordisk, Saxenda, which has been on the market since 2014, which Enel sometimes prescribes to her pediatric patients who are struggling with obesity.
The primary side effects reported after the use of Wegovy in clinical trials have affected the digestive system. Nausea, diarrhea, vomiting, constipation, abdominal pain or intestinal infections.
Eneli says that such side effects և their frequency is milder than the previous problems. That good safety profile could mean that the drug is “less likely to come with unpredictable risks,” he says.
But the new drug will be of little use, he says, to other obesity doctors if it is not available to patients.
“Before I bring that medicine back to my patients, I look at the insurance on the left side of my screen, because that’s going to determine if I’re going to introduce it,” said Stanford doctor Harford. “If it is not available, as I said, I will not raise it.”
Stanford says his patients who use existing obesity medications do unusual things to keep the cover so they can afford to stay on medication.
“At the hospital, my patients, a few nurses were still working, they had to retire so they could stay on their injections,” says Stanford, “because it was so good for them.”
Why are some people willing to pay out of pocket?
Some people, such as 42-year-old David Schizley, say he would consider paying for Wegovy even if he had to pay the full price of the sticker. From 2019, a correctional officer in Hanford, California, tried to lose weight on a variety of low-fat, all-meat-rich vegetables without success. Her weight has led to other health concerns, including blood fats and heart disease, forcing Schizley to think about her 5-year-old son.
“I want to see him for many years, I do not want to have a stroke,” he said. “I do not want to have diabetes. I want to be by his side. So for me personally [monetary cost] It’s not astronomical if it can give me some time. “
Wegovy manufacturer Novo Nordisk is negotiating with insurers and acknowledges that it is important to have health insurance coverage for its drug. The problem, says Douglas Langa, executive vice president of Novo Nordisk in North America, is forcing doctors, patients, and politicians to recognize obesity as a disease.
“There is a medical component [obesity] which must be recognized; “This is a state of illness, like any other disease we have to treat,” Langa said. He says 40% of private insurers are covered by Saxenda, the same slimming drug that the company makes.
That’s what Langa says to insurance companies, based on why Wegovy prescriptions should be covered. His company is also heavily lobbying Congress for legislation that would allow Medicare to cover obesity drugs. It makes financial sense, he argues, because obesity is a radical disease that underlies many other: diseases
“We believe insurers understand that [untreated obesity] “It’s the gateway to 60 other health conditions,” says Langa. It is difficult to ignore the need, he adds. More than 100 million people in the United States alone are battling obesity.