One major problem? Primary care physicians have been reluctant to prescribe the drugs. One issue is that doctors today aren’t typically trained in addressing obesity, and some still take the antiquated view that the disease is solely a lifestyle rather than a medical issue. Until that group gets more comfortable using these treatments, “I fear that all of these advances are going to remain on the shelf,” says Kushner, who consults for Novo Nordisk and led a Phase 3 study of Wegovy.
Affordability is also a huge issue. Wegovy was launched with a monthly price of more than $1,600, and insurance coverage has been spotty. A patchwork of laws dictate access to weight-loss drugs around the country, making them more accessible in some states than others. In Massachusetts, for example, private insurers will pay for obesity drugs, but Stanford says getting Medicaid to cover the drugs for her patients has remained difficult. In Pennsylvania, meanwhile, a bill that would allow the treatments to be covered for state Medicaid recipients has inched closer to passing after languishing for years. And Medicare currently excludes coverage of obesity drugs completely.
Also worth considering: The story about the long-term safety of this new generation of drugs is still being written. Past experience in the weight-loss arena has shown that side effects can emerge after the drugs hit the market. That worry is compounded by the drugs being potentially used in situations where there’s no evidence for their efficacy or safety—namely, in people who aren’t considered medically obese, but would like help shedding pounds. (Elon Musk, for example, recently made headlines when he credited his fitness to fasting and Wegovy, though it’s not clear he actually would qualify for the treatment.)
The demand for the treatments is indisputable. But meeting it—and thus hitting the high end of all those lofty sales forecasts—will require structural changes in how these drugs are prescribed and covered by insurance.
Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.
This article was provided by Bloomberg News.