January 5, 2024 — Eli Lilly, the maker of the anti-obesity drug Zepbound, this week Lily Direct, It’s a direct-to-patient portal, and some patients can get the drug for as little as $25 a month.
The move is seen as a major change in the way these popular medicines reach patients.
For many people, 42 million with the Americans obesityWeight loss drugs like , Wegovy, Saxenda, and the newest Zepbound can be a godsend to help you lose the extra weight you’ve been struggling with for decades or even a lifetime.
However, for many eligible people, these drugs are extremely difficult to obtain. Drug shortages are one barrier, as is the cost, which can run up to $1,300 a month and is not covered by insurance.
But 2024 could be a brighter year thanks to Lilly’s new portal and other developments.
- Private health insurance coverage remains variable, but may be improving. Congress is fighting a 2003 law that barred Medicare from paying for drugs if prescribed for obesity.
- A new study finds that semaglutide (Wegovy) can reduce the risk of recurrent strokes, heart attacks, and death from cardiovascular events in people who are obese and have pre-existing cardiovascular disease (or heart or blood vessel disease). Experts said this discovery needed to be made. Attention health insurance companies.
Also called GLP-1 agonists, this drug works by activating receptors for hormones (such as glucagon-like peptide 1) that are naturally released after meals. The result is increased satiety, which can lead to weight loss of up to 22% in some people. The drug is approved for people with a body mass index (BMI) of 30, or a BMI of 27 and at least one other weight-related health condition, such as high blood pressure or high cholesterol. The drug, which is injected weekly or more frequently, is prescribed along with advice about eating a reduced-calorie diet and increasing physical activity.
lily direct
Eli Lilly on Thursday launched a direct-to-patient portal, offering obesity drugs (as well as diabetes and migraine drugs) directly to consumers. Patients can access obesity medications through the telemedicine platform FORM. Lilly said patients will connect with an independent telehealth provider, who can supplement the patient’s current physician or, in some cases, replace inpatient care.
cost Depending on the scope of application, But for those with commercial insurance, a one- or three-month supply can cost as little as $25 a month. Lilly said people with insurance plans that don’t cover the drug could pay $550 for a month’s supply.
Eli Lilly officials did not respond to requests for comment.
Some obesity experts welcomed the new service. „Programs that improve the availability and affordability of these innovative medicines are welcome news for patients who have suffered for years,“ said Weill Cornell Medicine’s Comprehensive Weight Management Center in New York City. said Director Dr. Luis Aron. Time obesity researcher.
„Lily’s decision is a great one,“ agreed Dr. Caroline Apovian, a professor at Harvard Medical School and co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston. She is an obesity specialist. She said: „We’re trying to solve accessibility issues and do it responsibly.“
„The bottom line is that the consumer need and desire for these drugs is overwhelming, and the channels[of drug delivery]are It’s just not enough.“ “Eli Lilly is responding to market needs and honestly continues to grow.”
Neuwirth said there are still concerns and questions, saying, „To my knowledge, this is the first of its kind, especially in terms of drug manufacturers dispensing drugs directly in such a non-traditional manner.“ This is because it is about.”
He called for transparency between telemedicine providers and pharmaceutical companies to eliminate conflicts of interest.
The American College of Physicians, a group of internists, issued a statement expressing concern. Dr. Omar T. Atiq, the group’s president, said the group is „concerned about the development of websites that allow patients to order prescription drugs directly from pharmaceutical companies.“ Although information about in-person care is available, this direct-to-consumer approach primarily centers around the use of telemedicine services to prescribe the drug manufacturer’s products. ”
The group argued that there should be an established patient-physician relationship or that care should be provided in consultation with a physician who has an established relationship (the latter option being offered by Lilly). “These direct-to-consumer services can confuse patients or give them incorrect information about medicines.”
Heart attack, stroke relief benefits
previous the study GLP-1 drugs such as Ozempic (semaglutide), which the FDA approved to treat diabetes, have also been found to reduce the risk of cardiovascular diseases such as stroke and heart attack. now, new research Wegovy found that semaglutide at doses (usually slightly higher than Ozempic’s doses for diabetes) had similar benefits in people without diagnosed diabetes but who had obesity and cardiovascular disease. did.
In a clinical trial sponsored by Wegovy’s manufacturer, Novo Nordisk, half of more than 17,000 obese patients were given semaglutide (Wegovy). The other half received a placebo. He found a 20% reduction in strokes, heart attacks, and deaths from cardiovascular disease over a 33-month period in patients who took Wegovy compared to patients who took a placebo.
The study’s findings are „tremendous,“ Aronne said. The results demonstrate that even people who are obese but do not have diabetes can benefit from treatment with cardiovascular benefits. Although further analysis is needed, the important point is that the study showed that weight loss is associated with improved important health outcomes, he said.
As more research progresses, he said, it will be harder for insurance companies to refuse medications in the face of these findings, which promise to reduce long-term medical costs.
Insurance coverage
In November, the American Medical Association policy Encourage insurance coverage of evidence-based obesity treatments, including new obesity treatments.
„No single organization will be able to convince insurance companies or employers to cover this,“ Aronne said. “But I think it helps when prominent organizations like the AMA speak up and join the chorus.”
According to one study, coverage of GLP-1 therapeutics could nearly double in 2024. investigation Accolade, a company that champions and delivers personalized health care, released a survey of 500 HR decision makers in October. When the survey was conducted in August and September, 25% of respondents said they currently offer insurance, while 43% said they intend to offer insurance in 2024.
David Allen, a spokesman for America’s Health Insurance Plans, a medical industry group, said in an email: ”
„Clinical leaders and other experts at health insurance companies regularly review the evidence for all types of treatments, including obesity treatments, and make decisions on everything from lifestyle changes and nutritional counseling to surgical interventions and prescription drugs,“ he said. „We offer patients multiple options,“ he said. ”
Allen said the evidence that obesity drugs help with weight loss is „still evolving.“
„And some patients experience adverse effects associated with these drugs, such as vomiting and nausea, which can lead to weight regain when the drugs are discontinued,“ he said.
Some people are fighting for Medicare coverage, but some experts say the costs would be prohibitive. bipartisan bill, treatment and reduction The Obesity Act of 2023 would allow drugs used to treat obesity and manage weight loss in overweight people to be eligible for Medicare prescription drug benefits.Some say it’s an uphill climb, citing Vanderbilt University. analysis They found that administering the drug to just 10% of Medicare patients would cost between $13.6 billion and more than $26 billion.
however, white paper Researchers at the University of Southern California concluded that the value to society of covering Medicare recipients‘ medications would be nearly $1 trillion over 10 years, citing savings in hospitalization and other medical costs.
Apobian said comprehensive insurance coverage is needed. She said private insurance plans, Medicare and Medicaid all need to recognize the importance of covering what is now known to be a life-saving drug.
Broader coverage could also reduce the number of patients who obtain obesity drugs from unreliable sources to save money and suffer side effects.of FDA warned Counterfeit semaglutide in December.
long term outlook
Research shows that, at least for most people, continued use of bariatric drugs is necessary to maintain weight loss.in study In looking at the proportion of patients taking Zepbound, Aronne et al. found that while they regained weight when they stopped taking the drug, those who continued taking it maintained their initial weight loss and even gained weight. I discovered that. While some people may only be able to use the drug occasionally, „the vast majority will need to take it chronically,“ Aronne said.
Apobian said obesity, like high blood pressure and other chronic diseases, requires ongoing treatment. No one suggests discontinuing antihypertensive drugs that stabilize blood pressure. The same should apply to obesity drugs, she says.
Apovian consults on FORM, the telemedicine platform Lilly uses with LillyDirect, and also consults on Novo Nordisk, which makes Saxenda and Wegovy. Aronne is a consultant and researcher for companies such as Novo Nordisk and Eli Lilly.