Well being
Getting the high-demand, injectable medication requires persistence and a good quantity of luck, based on consultants.
When she prescribes the favored weight-loss drug Wegovy, Dr. Angela Fitch sends sufferers on a quest she likens to “The Starvation Video games.”
They should name drugstores over a number of days to seek out one with the correctly sized first dose. Then they’ll do this once more for his or her second dose, and possibly the third. And that’s provided that the affected person has insurance coverage or the means to afford a drug that may value greater than $1,300 a month.
“This isn’t for the weak-willed,” stated Fitch, who’s president of the Weight problems Drugs Affiliation and in addition consults for drugmakers.
Provide issues and insurance coverage issues have made it tough for individuals to begin — and keep on — Wegovy and related drugs which are remodeling weight problems therapy, based on docs and sufferers across the nation. They are saying getting the high-demand, injectable medication requires persistence and a good quantity of luck.
Folks beginning on Wegovy should take injections of progressively growing power earlier than they attain the so-called upkeep dose that they keep on.
The drug’s maker, Novo Nordisk, says that demand has compelled it to limit the availability of these smaller, preliminary doses within the U.S. The corporate is also warning these taking one other weight-loss drug, Saxenda, to anticipate problem filling prescriptions “for the rest of 2023 and past.”
One other drugmaker, Eli Lilly, has stated it expects tight provides till 12 months’s finish for its diabetes therapy Mounjaro, which is also prescribed for weight reduction.
Discovering Wegovy can turn into a part-time job for sufferers, stated Dr. Diana Thiara, medical director of the load administration clinic on the College of California, San Francisco.
Thiara stated some wind up driving 45 minutes or extra to get prescriptions crammed, a barrier for hourly employees who can’t go away their job and for individuals with out vehicles.
“It’s often sufferers who’re a bit of bit extra privileged, capable of take off from work to go make these drives,” Thiara stated.
One in all Fitch’s sufferers, Mike Bouboulis, has taken Saxenda, Mounjaro or Ozempic, a Novo diabetes drug with the identical energetic ingredient as Wegovy, since round 2019. It turned a lot more durable for him to seek out the medication previously 12 months, after their reputation exploded.
Refilling a prescription concerned calling 5 to seven pharmacies.
“All of them know what you’re calling for, and so they all have the identical reply: ‘I don’t know. We’ll see tomorrow,’” stated the 35-year-old small enterprise proprietor who lives exterior Boston.
Pharmacy technician Lizzy Nielsen used insider data to begin Wegovy earlier this 12 months.
She frequently checked drug wholesalers’ provide lists, refreshing her display screen every morning, after which ordering Wegovy for her pharmacy as quickly as she noticed it in inventory.
“I used to be actually fortunate … as a result of that’s when it was like beginning to be consistently back-ordered,” the 42-year-old West Springfield, Massachusetts, resident stated.
Whereas sufferers have needed to cope with shortages of many drugs previously 12 months, these taking weight-loss medication can face protection issues too.
The federal Medicare program for individuals age 65 and older doesn’t cowl weight problems medicines, however some privately run Medicare Benefit or Medigap plans do, based on Novo. Protection from Medicaid applications for individuals with low incomes varies.
Medical doctors and sufferers say many insurers have stopped protecting Ozempic and Mounjaro exterior their permitted use for diabetes. Some insurers and employers don’t pay for Wegovy.
Novo Nordisk even gives a kind letter on its Wegovy web site to assist docs request protection.
Bouboulis, the Boston-area resident, stated his insurer stopped protecting Mounjaro earlier this 12 months. He then tried switching again to Ozempic however discovered that additionally was now not lined.
He’s taking low doses of leftover Ozempic till he can discover protection.
“I do know the insurance coverage corporations don’t need to pay, however between (them) and the pharmaceutical trade, they should discover some form of good center floor as a result of these drugs, they’ll save individuals’s lives,” stated Bouboulis, who has misplaced round 80 kilos since he began taking them.
Employers and insurers that do pay for the weight-loss therapies typically require sufferers to get pre-approval or to first attempt different methods like food plan and train.
Some require sufferers to indicate they’ve misplaced 5% of their physique weight after six months on the medication to be able to proceed protection. Provide issues make that arduous, Thiara famous.
“Numerous sufferers usually are not staying on it persistently as a result of they’ll’t get it,” she stated.
Dr. Laura Davisson estimates that lower than 30% of her sufferers with insurance coverage by means of an employer or a person plan have weight problems medication protection.
Davisson directs a weight-loss program in West Virginia, a state that persistently ranks as having one of many highest weight problems charges within the nation. The state’s Medicaid program doesn’t cowl Wegovy, however neighboring Pennsylvania’s does.
“For me, it’s both they’ve protection by means of insurance coverage, or they’re not taking it,” she stated. “Nobody can afford it.”
Protection could enhance over time, because it has with different weight problems therapies like bariatric surgical procedure.
About 46% of huge U.S. employers cowl weight problems medicines like Wegovy, based on the advantages guide Mercer. One other 18% are contemplating it. Mercer’s consultants say employers are nonetheless attempting to find out about how the added value will have an effect on them and what different help sufferers may have.
Dr. Deborah Horn says she thinks provide issues and protection will ultimately clean out, however it might take a pair years. She famous that the FDA could quickly approve Mounjaro to deal with weight problems, which might enhance protection.
Drugmakers are also creating different weight-loss drugs, together with easier-to-take capsules.
Within the meantime, extra sufferers are realizing that they’ll get medical assist for his or her illness and don’t should handle it on their very own, stated Horn, an weight problems medication skilled at UTHealth Houston.
“I really feel like that is the start of the change in weight problems care, the place we are going to see yearly higher and higher drugs coming to market and folks getting their illness underneath management,” she stated. “We’re simply within the exhausting half … proper now.”
The Related Press Well being and Science Division receives help from the Howard Hughes Medical Institute’s Science and Instructional Media Group. The AP is solely liable for all content material.