Well being
Getting the high-demand, injectable medication requires persistence and a good quantity of luck, in accordance with 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 must name drugstores over a number of days to search out one with the correctly sized first dose. Then they’ll try 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,” mentioned Fitch, who’s president of the Weight problems Medication Affiliation and in addition consults for drugmakers.
Provide issues and insurance coverage problems have made it troublesome for folks to start out — and keep on — Wegovy and related medicines which are remodeling weight problems remedy, in accordance with 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 must take injections of progressively rising energy earlier than they attain the so-called upkeep dose that they keep on.
The drug’s maker, Novo Nordisk, says that demand has pressured it to limit the provision 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 mentioned it expects tight provides till yr’s finish for its diabetes remedy Mounjaro, which is also prescribed for weight reduction.
Discovering Wegovy can change into a part-time job for sufferers, mentioned Dr. Diana Thiara, medical director of the burden administration clinic on the College of California, San Francisco.
Thiara mentioned some wind up driving 45 minutes or extra to get prescriptions crammed, a barrier for hourly employees who can’t depart their job and for folks 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 mentioned.
Certainly one of Fitch’s sufferers, Mike Bouboulis, has taken Saxenda, Mounjaro or Ozempic, a Novo diabetes drug with the identical lively ingredient as Wegovy, since round 2019. It turned a lot more durable for him to search out the medication prior to now yr, after their recognition 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,’” mentioned the 35-year-old small enterprise proprietor who lives outdoors Boston.
Pharmacy technician Lizzy Nielsen used insider data to start out Wegovy earlier this yr.
She recurrently checked drug wholesalers’ provide lists, refreshing her display 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 continuously back-ordered,” the 42-year-old West Springfield, Massachusetts, resident mentioned.
Whereas sufferers have needed to take care of shortages of many medicines prior to now yr, these taking weight-loss medication can face protection problems too.
The federal Medicare program for folks age 65 and older doesn’t cowl weight problems medicines, however some privately run Medicare Benefit or Medigap plans do, in accordance with Novo. Protection from Medicaid applications for folks with low incomes varies.
Docs and sufferers say many insurers have stopped masking Ozempic and Mounjaro outdoors their accredited use for diabetes. Some insurers and employers don’t pay for Wegovy.
Novo Nordisk even provides a kind letter on its Wegovy web site to assist docs request protection.
Bouboulis, the Boston-area resident, mentioned his insurer stopped masking Mounjaro earlier this yr. He then tried switching again to Ozempic however discovered that additionally was now not coated.
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 sort of good center floor as a result of these medicines, they will save folks’s lives,” mentioned Bouboulis, who has misplaced round 80 kilos since he began taking them.
Employers and insurers that do pay for the weight-loss therapies usually require sufferers to get pre-approval or to first attempt different methods like eating regimen and train.
Some require sufferers to indicate they’ve misplaced 5% of their physique weight after six months on the medication as a way to proceed protection. Provide issues make that onerous, Thiara famous.
“A whole lot of sufferers should not staying on it constantly as a result of they will’t get it,” she mentioned.
Dr. Laura Davisson estimates that lower than 30% of her sufferers with insurance coverage by an employer or a person plan have weight problems medication protection.
Davisson directs a weight-loss program in West Virginia, a state that constantly 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 insurance coverage, or they’re not taking it,” she mentioned. “Nobody can afford it.”
Protection could enhance over time, because it has with different weight problems therapies like bariatric surgical procedure.
About 46% of enormous U.S. employers cowl weight problems medicines like Wegovy, in accordance with the advantages guide Mercer. One other 18% are contemplating it. Mercer’s consultants say employers are nonetheless making an attempt to study how the added value will have an effect on them and what different assist sufferers may have.
Dr. Deborah Horn says she thinks provide issues and protection will finally clean out, however it might take a pair years. She famous that the FDA could quickly approve Mounjaro to deal with weight problems, which may enhance protection.
Drugmakers are also growing different weight-loss medicines, together with easier-to-take drugs.
Within the meantime, extra sufferers are realizing that they will get medical assist for his or her illness and don’t must handle it on their very own, mentioned Horn, an weight problems medication professional 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 medicines coming to market and other people getting their illness beneath management,” she mentioned. “We’re simply within the laborious half … proper now.”
The Related Press Well being and Science Division receives assist from the Howard Hughes Medical Institute’s Science and Instructional Media Group. The AP is solely liable for all content material.
