We could very well be at a crossroads for diabetes medicine. Eli Lilly’s latest drug could become the best-selling medicine of all time.
Unfortunately, it’s dragged down by one major downside, that being the fact it might not be as affordable as we’d like it to be.
Eli Lilly’s diabetes drug not expected to be covered by health insurers
The drug in question, Tirzepatide, is bound to get approval from the Food and Drug Administration during the year; if that were to happen, it’d be the third big weight loss drug on the market.
Semaglutide and Tirzepatide are the strongest weight-loss drugs on the market right now
My patients' from other medications aren't even in the same ballpark as these
— Bioenergetic Breaux (@ColliNof1) December 22, 2022
The other two are the recently approved Wegovy and Saxenda, both of which are tremendously expensive and produced by Novo Nordisk.
Despite all the buzz surrounding the new release, Eli Lilly’s spokesperson, Kelly Smith, refused to give any info regarding the drug’s price upon release.
However, that didn’t stop experts in the field from making speculations based on its competitors’ prices; a monthly supply of Wegovy totals around $1,500, whereas Saxenda will set you back $1,350 for each month of use.
Dr. David Rind believes if Tirzepatide were to be approved by the FDA, the only reasonable price for it would be $13,000 for a yearly supply, or $1,100 monthly, allowing it to compete in an already established market.
What sets Tirzepatide apart from the other two is that it helps the body break down sugar and fat more efficiently, rather than just reducing appetite.
Example of adult female w/ type 1 #diabetes who has struggled in adult years w/#obesity started semaglutide (#Wegovy) last January before insurance coverage changed; switched to tirzepatide (#Mounjaro) recently (on 5mg).
21% #weightloss + markedly reduced insulin requirements pic.twitter.com/RSipapFj65
— Karl Nadolsky (@DrKarlNadolsky) October 17, 2022
Obesity still not acknowledged by many medical experts
In smaller doses, each of the three drugs has been approved for treating diabetes. Currently, Eli Lilly’s drug goes under the name Mounjaro, which is still the only one not to be covered by insurance.
On the other hand, this doesn’t apply to patients suffering from obesity, as it’s got a certain social stigma surrounding it.
Dr. W. Scott Busch claims one of the main issues is that a lot of physicians continue to view it as a behavioral issue, rather than a medical one. This is what causes insurers to be reluctant when providing coverage for drugs intended to treat it.
Weight loss drugs continue to gain national attention as effective treatment options. #tirzepatide, also known as #mounjaro is the latest medication that’s still awaiting FDA approval for #obesity. Here's all you need to know about this medication. pic.twitter.com/wMijtyD7x5
— Christopher McGowan, MD (@DrMcGowanMD) December 29, 2022
At times, patients end up spending thousands of dollars out of their own pocket while trying to negotiate coverage with their health insurance.
Even then, private insurance companies offer coverage for obesity drugs only in their most expensive plans.
Sadly, none of this is going to change until the majority of people working in the medical field change how they view obesity.
Oftentimes, dieting, exercise, and willpower simply aren’t enough to solve the issue; with the stigma surrounding this growing problem, things will only get worse before they get better.
Shifting the opinions of medical professionals is extremely difficult; it may take legislative action for obesity drugs to finally receive coverage from insurers.
However, the benefits of the drug may swing the community in the right direction, and Butsch believes that now’s a good time as any for that to happen.