A doctor shares how his patients are trying to afford weight-loss drugs — and what happens if they can't

A doctor shares how his patients are trying to afford weight-loss drugs — and what happens if they can't
  • The high price of weight-loss drugs is frustrating for patients who can't access them, a doctor said.

  • Patients struggle to afford these drugs, leading to cycling, rationing, or using risky alternatives.

  • Insurance companies often don't cover the drugs, and it could take years for prices to drop.

Pharmaceutical companies are facing a new wave of criticism for the high price of groundbreaking weight-loss drugs.

GLP-1 medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have skyrocketed in popularity, helping people lose up to 15-20% of their body weight and even slash their risk of heart attack.

But a list price of around $1,000 per month or more means the treatments are out of reach for many patients.

It puts doctors in an awkward position, too — wanting to prescribe these potentially life-changing drugs, but knowing they could be sending their patients on a complicated financial journey.

"Patients that I speak to have tried nearly every strategy to obtain anti-obesity medications," Dr. Christopher McGowan, a gastroenterologist and obesity medicine specialist, told Business Insider.

Many insurers have dropped coverage in the past year, McGowan said.

"While it's clear that semaglutide and tirzepatide represent tremendous advances in obesity management, what does it matter if no one can afford them?" McGowan said.

The end result is that the people who need these drugs most are taking uncharted, unresearched risks to get the medications.

Patients are rationing doses to cut costs

GLP-1 medications work by mimicking a hormone in the body that helps regulate appetite and blood sugar.

The latest generation of these class of drugs, medications like Ozempic, Wegovy, Mounjaro, and Zepbound, are once-weekly injections.

The caveat is that in order to maintain the weight loss, you need to keep taking the drugs, but McGowan said that's just not possible at the current price point.

"This is why we so often see patients cycling on and off medications. Unfortunately, short-term use doesn't translate into long-term benefit," he said.

In some cases, patients say they've tried to space out their doses, and found their weight creeping back up.

Copycat drugs are dominating the online market

A booming industry of websites and telehealth companies have jumped at the chance to sell patients their weight loss drugs for cheap, but there's a major catch, according to McGowan.

These providers are offering compounded semaglutide and tirzepatide, which contains the same active ingredient as branded products, but isn't FDA-approved.

"The compounded GLP-1 market has absolutely exploded," he said. "These drugs are everywhere and can be obtained with incredible ease and at a fraction of the cost of brand-name medication. However, this entirely unregulated industry presents significant risks related to quality, safety, and efficacy."

It could take years for prices to drop

Political pressure on pharmaceutical companies may move the needle when it comes to drug prices, according to Ted Kyle, a health professional with decades of experience in policy, marketing, and obesity care.

"It's going to be really messy but five years from now, prices will more reasonable, access much better, and more people will be getting care with a whole lot less blame and shame," Kyle told Business Insider.

The competitive pressure will also help drive prices lower as companies aim to attract consumers back to their brand with cheaper options for weight-loss drugs.

But McGowan said he isn't optimistic that the situation will improve for his patients in the near future.

"We can beg insurers to cover medication and plead with pharmaceutical companies to lower prices, but there simply isn't any incentive for them to do so right now," McGowan said.

Read the original article on Business Insider