KANSAS CITY, Mo. — A new class of drugs have taken over the market: some treat type 2 diabetes, and some focus on weight loss.
Semaglutide (commonly known as Ozempic or Wegovy) and Tirzepatide (commonly known as Mounjauro or Zepbound) can cost more than $1,000 a month.
While the CDC reports 40% of U.S. adults are obese, many of the patients who would benefit most from these drugs can’t get them because of cost or supply issues.
KSHB 41's Elyse Schoenig looked deeper in this issue, by talking with:
- a doctor studying these drugs
- a patient taking Ozempic
- a professor studying the supply chain shortage
- a professor who explains the role of insurance
- a nonprofit pharmacy director
Patient
Jacque Long's past is unrecognizable to her now.
"Before, I couldn't; I was hardly mobile,” Long said. “I wanted to sleep all the time; I wanted to eat all the time; I didn't wanna go anywhere. It just hurt to move."
She's battled diabetes and major heart problems all her life.
Her doctors at Saint Luke's mid-America Heart Institute in Kansas City said even her open-heart surgery and weight-loss surgery weren't enough.
"I remember getting my Master's degree and walking across that stage not as proud as I should've been, because I couldn't hardly walk across the stage to receive an honor that I worked hard for because I could hardly breathe,” Long said.
Then one day, another option became a possibility. Jacque began taking weekly semaglutide injections through a cardiologist at St. Luke's — commonly known as Ozempic or Wegovy. She received these medications as a part of clinical care due to a combination of Type 2 diabetes and heart disease.
The results were life changing. Long not only lost weight, but experienced lifestyle-defining changes. She found herself able to and wanting to exercise. Her sugar levels and cholesterol levels went down. Her life became better.
"I've gotten a second chance at life, and I'm not gonna mess it up,” Long said.
Doctor
Dr. Mikhail Kosiborod, who has treated Long as a patient, has also led two clinical trials on these drugs.
One of the trials focused on patients who presented heart disease or heart failure and were obese or overweight.
The other focused on patients who presented heart disease or heart failure and diabetes, and were obese or overweight.
"Obesity is not just an accident in these patients, obesity is driving the development and progression of heart failure," Kosiborod said. "In order to treat heart failure in these patients well and effectively, we have to target obesity."
Dr. Kosiborod is a cardiologist and VP of Research at Saint Luke’s Mid America Heart Institute. He also has served as a consultant for Novo Nordisk and several other companies that make or are developing anti-obesity medications, too.
In both of his trials, patients were randomly assigned a weekly injection of Semaglutide — commonly known as Ozempic or Wegovy — or a placebo.
He followed these patients for a year.
Patients who took the weekly Semaglutide injections saw a drastic improvement in their symptoms: shortness of breath, fatigue, swelling, ability to exercise, and yes, weight loss.
"For this particular outcome, the symptoms and physical limitations due to heart failure, it's the best results we've gotten with any medication in this type of heart failure so far today,” Kosiborod said.
Kosiborod said it’s important that these medications are prioritized for patients with heart disease and/or diabetes.
But he agrees that the weight-loss aspect is a crucial part of these patient's overall health.
"I think what we are learning very rapidly is that managing obesity and targeting obesity is going to become a central factor in practice of medicine," Kosiborod said.
Targeting obesity could be the answer to countless health epidemics — but that's not the current reality.
Supply chain expert
"Ideally if cost wasn't an issue, and supply chain and having enough medication around was not an issue, it becomes a different discussion," said Larry Wigger, a supply chain management professor at UMKC. "But that's not the world we live in right now."
Wigger studies the impact drugs like these have on supply the supply chain.
"There's definitely a supply shortage," he said.
Wigger says the attraction to losing weight has increased the demand for this class of drugs.
"Demand is through the roof; they're trying to get production cranked up, and that's why we have a supply shortage," Wigger said. "Because that demand is just outstripped."
He believes drugmakers will catch up.
"If we can get diabetes under control, we'll improve things. We'll improve health outcomes, and we'll lower healthcare costs. It's awesome. That's a whole different level of demand,” he said.
But that level of demand comes with a price tag of its own.
Health insurance expert
"When you have a drug like Ozempic, my understanding is the list price is around $1300 per month," said Christopher Garmon, a professor in UMKC's School of Management.
Garmon looks at medical costs and health insurance plans in some of the classes he teaches at UMKC.
"There are some employers that will cover these drugs for weight loss," he said. "Even though Medicare won't, Medicaid won't, and a lot of private insurance won't just for weight loss."
Medicare Part D patients can get coverage for weight loss drugs, as long as there's an added health benefit.
According to the KFF, states decide whether Medicaid patients are covered.
"If they really reduce obesity, that could lower healthcare spending in the future, and that could benefit insurers in the future," Garmon said.
He said more research is needed on the long-term effects of covering these drugs.
Nonprofit pharmacy director
Patients who are under-insured don't have time for the supply to adjust.
"Some of our patients who may only be paying a couple dollars for a prescription would be looking at about $1000 for those that may be available,” Michael Fink said.
Fink is the pharmacist in charge at Pharmacy of Grace. The nonprofit serves patients who are uninsured or under-insured.
"When we're trying to supply a patient with these medications and they're not available, moving to an affordable product isn't always an option for them,” Fink said.
He's watched awareness of weight-loss drugs impact his patient's prescriptions for diabetes medications.
"Patients are desperate to find (these drugs), whether it is for diabetes or for weight loss, to maintain and reach the goals that the doctor and they have set,” Fink said.
Obstacles and all, these drugs are just one way people are searching for a happier, healthier future.
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