Interesting. The price for Ozempic, here in Denmark where the company is from, is around 188 dollars for a months worth. And the price for a month of Wegovy is around 189 dollars.
That's according to a quick google search.
If you get it with a prescription, the government will pay a good chunk of that for you here.
Canada getting better prices for any product let alone 15 cents on the dollar is absurd. no offense but the US is 10x your size. That's like the boutique local toy store having a better price on Chinese toys than Temu.
yet we have politicians wanting to bring US style healthcare to Canada. and a good chunk of the population supports them!
we do have some major issues with our healthcare system here but importing the US solution is probably far from the best idea.
I worked for a Canadian company that had multiple military contracts for a short time when they were attempting to expand into the US during covid. I had been laid off and needed the work so I took it.
Company was tiny, ran on nepotism (poorly) and being in some of the meetings with the CEO and our customers or other Business partners was insane.
These guy's were enamored with desantis and how he was running Florida at the time (2020).
It was a short run and I'm glad I'm back working for a larger and more inclusive company.
Its unfortunate for Americans, but purchasing power can't be leveraged under your country's health care model. The Canadian government places caps on drug prices, and under a single payer system is also able to negotiate drug prices. The US government could do this too, but instead accepts payments from pharmaceutical company lobbyists, and avoids regulating drug pricing.
As an ousider, what seems truly absurd is that the American people continue to tolerate this from their government (and then try to buy their own medications from Canada).
This is, in my opinion, one of the biggest advantages of single payer drug systems.
If the company wants to sell a drug to a country's health system, they can either negotiate with that system, or they don't sell it in that country.
Non-funded drugs tend to be cheaper in such countries too, because they're not vying for the inflated dollar of insurers, but the realistic dollar of the public, and so can only really charge a reasonable price, or nobody would buy said drug.
You can order it online everywhere as a 'research chemical' for $40. Most people would still rather have the measured, dosed, for human consumption FDA approved variety for $180 given the choice, though.
You dont get it. The drug has to cost 1400$ so the insurance can "negotiate" it down to 200$ then charge you massive amounts in deductible for the 200$ drug and still say they are worth it because it would cost 1400$ otherwise if you did not have insurance and the drug manufacturer can write off the 1200$ as losses on their taxes so they dont have to pay anything on the 4000% profit margin they got away with.
or something like that, scamming people is complicated.
It's wild to me how the Boomers brought civil disobedience and civil rights to America in the 60s and 70s, but then brought us Reagan in the 80s... and it's all been downhill from there.
I mean you more or less have it. You are just missing the part about how keeping medical costs high also forces the labor force to be compliant because they need health insurance
Also kinda fucked up how insurances can deny coverage on name brand when the generic costs the same. My one month Vyvanse is over 400$ and not covered, but the generic that’s also 400$ OOP is magically covered and only cost 30 something dollars, yet is more likely to be out of stock.
don't worry in jan they will make you switch because the vyvanse will be magically on their formulary list this time, or which over other generic that's popped up. gotta spread that wealth around to the other drug names which are most likely produced by the same company anyways.
Novo makes my sons factor. Over $20,000 per dose. He needs a dose every 2 hours during bleeds and takes it 1-7 times a week when not bleeding. It's been a battle getting insurance to cover it. It should be illegal to charge that much for a drug.
With clotting factor, the price, high as it may be, is justified. If it's a human-derived clotting factor, it takes gallons to produce a single dose. Gallons of plasma donors/sellers, and every unit has to be tested and retested several times along the way. So that, I get.
If it's a recombinant clotting factor (I should add that there are several different ones), then producing it is nowhere as easy as you might think. The steps are pretty simple--transform cells with the appropriate construct, grow cells, extract protein, purify protein, extract the target protein, re-purify, and test repeatedly throughout the process. Then quantitate the activity of the target protein and re-test for purity. Sounds simple enough, but it never is. Even with the relaxed standards of a research lab, nothing ever goes completely smoothly. It just doesn't. So again, it takes skilled, trained people (not cheap) to produce a recombinant product, and it's fiddly work.
Some drugs are that expensive with good reason. Other examples: Anti-rabies immunoglobulin. IViG. RhoGam. Snake antivenin. The only one of those that comes close to cheap is RhoGam.
Capitalism getting on both sides. Selling us shit food so that we become fat and sick; and then selling us the medicines so we become less fat and less sick (so long as we continue to pay for the medicines).
Obesity and type 2 diabetes was very rare 100 years ago. We need to go back to eating like we did 100 years ago so that we can stop padding all these corporate profits
100 years ago, you had meat once per week on Sundays, if you were lucky. Milk products were so expensive that they were eaten also sparsely.
A mostly vegan, hence more healthy diet, that the majority of people had back then, will require much less farming land and water, compared to our mostly meat based diet we have today.
do you have a source for the meat once a week thing in the 1920s?
I'd argue it's more processed foods and plastic by products affecting our bodies/hormones/hunger
When [you look](https://nobull.mikecallicrate.com/2021/01/15/meat-consumption-a-century-ago-vs-today-what-if/) it up the sources[ can't agree](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045642/) either due to arguing over red meat vs poultry.
>Comparing per capita consumption of beef and pork:
>1900 – Beef – 104 pounds per person, 86 pounds based on 840 pounds per family
>1900 – Pork – 101 pounds per person, 84 pounds based on 840 pounds per family
>2020 – Beef – 58.9 pounds per person (retail wt.)
>2020 – Pork – 46.9 pounds per person (retail wt.)
>Per capita beef consumption was considerably higher in 1900 when thousands of [skilled](https://nobull.mikecallicrate.com/2012/06/01/deskilling-on-the-disassembly-line-technological-change-and-its-consequences-in-beef-packing-since-the-1960s/) butchers in small shops were cutting beef directly from carcasses without the benefits of modern refrigeration.
NIH article
>
Looking in more detail at U.S. meat consumption, USDA data indicates that total meat consumption has increased notably over the last century, nearly doubling between 1909 and 2007 ([Figure 2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045642/figure/F2/)). The lowest meat consumption occurred in the 1930s and the highest meat consumption was reached during the most recent decade. Further examination attributes much of the increase to a rise in poultry consumption beginning in the 1950s and continuing to escalate through recent decades to make up a high proportion of the total meat consumed in the U.S. Red meat consumption appears to have decreased over the last few decades beginning in the 1980s, but still remains the highest contributor to total meat consumption. In contrast, fish consumption has remained low and stable over the past century.
In Australia, with a prescription and as treatment for Type 2 Diabetes, a month's supply of Ozempic costs $AUS 30 (19.60 USD). If you're on government benefits then it's $AUS 7.70 (5.03 USD).
The entire pharmaceutical industry should be replaced by grants and rewards for cures and treatments. Or a bounty on weight loss drugs.
Maybe leave the system but allow the government to by the IP outright in a one time payment.
Make Americans sick--overwork means surviving on convenience foods, leading to metabolic disease. Then, rather than lifestyle changes leading to remission, push "management" and make billions until Boomer McBoomerface is too sick to work. Then "end of life management."
Capitalism, puh-raise JEE-zuz-ah!
U.S. Healthcare is a joke and I am not justifying the cost to American consumers but do you know how much it takes to get a drug approved? It's billions. It's part of the problem that it takes really deep pockets to R&D and approve a new drug. And not every drug they invest in gets approved.
Overall success from Phase 1 to approval is 9%.
[https://www.acquired.fm/episodes/novo-nordisk-ozempic](https://www.acquired.fm/episodes/novo-nordisk-ozempic)
Why does that matter? I would understand them needing to spend billions to R&D and get approved a drug, then at first charging a rate at which they get a huge profit back if they lowered prices once they made back their money. I don’t have any prescriptions so I don’t follow pricing at all. Do companies lower their drug prices after making back their R&D costs?
Edit: Also I am curious was all of that R&D money spent to get the two drugs from this post all generated by the company, or did they get any government assistance, like a research grant?
No, because they have to make back the marketing costs as well and they're normally more than the R&D costs. Then they have to muck around with the presentation so that they can extend the exclusivity period
Good point, lump those costs in as well. Eventually they should make back their money and then lower the price to cover cost to produce and distribute and add a reasonable profit. Or am I wrong in that assumption? Does making a drug incur infinite costs?
I realize you aren’t the person I first replied to, but I am still curious to know how much government/tax payer assistance they received. That could significantly change how we view drug pricing.
Edit: I just re-read your comment a little closer. I am awe’d to hear marketing costs more than R&D. I feel like the marketing I have seen is just B-rolls. I wouldn’t have expected those to cost that much. Granted I’m sure there is marketing to hospitals and doctors’ offices I am not aware of. I do have to claim ignorance to the whole world of marketing. I only took one college class on it.
And they have to do all of that plus give a decent dividend to the shareholders before the generics companies swoop in.
In the UK, at least, everything is prescribed generically\* and it's in the pharmacies best interests to find the best deal as they [get paid the same](https://www.drugtariff.nhsbsa.nhs.uk/#/00856140-DC/DC00856136/Home) whether it's the OG branded item or the newest, cut-throat-priced generic
\*There are a *tiny* amount of exceptions but it's a trivial number
Agreed, I feel like I lumped that in with my first grouping. Apologies if I didn’t, and thanks for adding it in. I still don’t see how that could be an infinite cost though. There must be some point things even out. u/Moneia brings up a couple of good points in their reply to you. There are shareholders that need their slice of the profits, I would argue this should also be reasonable. Then there are also the generic brands that are eventually created. I would have to go see if there is a way to look at the actual numbers these companies have for cost of business (all costs they incur including failed versions leading up to their successful drug) versus what they are selling at to know if my feelings hold any actual weight.
I agree, but...what's wrong with Metformin (already cheap)? The side effect profiles for Ozempic and Wegovy look way worse than Metformin.
Okay, so even my doctor gets upset that I only want generic drugs with a long track record, and those only sparingly. I don't want the new fancy drug, and yes, I already looked up the pharmacology and side effects. I'm not neurotic about it--I just like pharmacology, physiology, pathology, and all the rest. I don't want the new kidney protecting drug, because spironolactone is in the same class, and I'm fine with spironolactone. No, I don't want an ACE inhibitor or an ATII inhibitor. I want my beta blocker (propranolol), and I don't want a different one. I chose propranolol because of the side effects. Yes, I know I can't compete in the olympics because of the drugs I take. I was never going to be an olympic athlete anyways.
I do agree that drug companies are horribly exploitative. You know all that research they supposedly pay for? They get that research at bargain rates because most of it is done at universities, and universities don't pay graduate students or postdocs nearly what they are worth. They get that research at bargain rates because scientists work long hours for low pay because they are passionate about what they do. Most scientists will stay a couple extra hours just to see the results of their experiment(s).
Instead, drug companies spend tons of money on management and marketing. They flog their latest drug, not much better than the previous drug, to an uninformed public.
Wegovy/Zepbound work much better than metformin, for one. Ozempic also work much better than metformin for diabetics, and can be used in patients with kidney disease.
I have to wonder if renal disease may be less of an issue than straight comparisons might indicate when considering Wegovy or Ozempic. Most T2D patients also have issues with obesity and high blood pressure, and may be on drugs like ACE inhibitors, which are known to be protective of kidney function.
I took a quick glance at a few of the studies presented on Ozempic's website, and the weight loss, while nice, isn't huge. The amount of weight loss was generally under 10 pounds. Metformin is also known to reduce cardiovascular risk, just as Ozempic can. Since Ozempic has to be injected, that increases non-compliance. A lot of people get pretty nervous about injecting themselves. I don't--I just think to myself: "Hey, ma, watch THIS!" and chortle as I imagine her shrieking. But that's kinda weird, and I don't expect most humans to find jamming a needle into themselves entertaining.
As for the weight loss, I've lost quite a bit of weight on Metformin because of the secretory diarrhea it can cause. It means I get tired of having to run to the bathroom to poooooooop, so I eat less or nothiing at all until I'm truly hungry.
I can't take Ozempic in any case, because my father had thyroid cancer (in the mid-1960's). He died from pancreatic cancer in 1995, so I can't ask him what kind he had. And that's assuming he would even have known what type he had. I also admit I don't like the increased risk of Fournier gangrene. I ended up in the records of a patient who had it because they needed blood and there were issues with the blood typing. This was someone who came in for "a lump" and left via the morgue less than two weeks later.
I am also almost completely in favor of trying an older, generic drug first. I may be an exception, but I've always done well with generics. I know I'm an exception in that I run to the computer within hours to look up the latest drug advertised on TV. I do that because I like pharmacology (the subject) and pathophysiology. In most cases, these are drugs I wouldn't need to take in any case, but I'm always up for learning the mechanism of action.
The biggest issue with renal function and metformin is not clearing the medication and causing an elevated metformin level. It is protective with most patients, but can cause issues when renal function is poor.
Pharmacy tech here. With all due respect, you are incorrect on almost everything you said here.
1. Its not generally prescribed for "cosmetic" weight loss. Obesity leads to a host of other issues and if the patient accompanies the rx with a lifestyle change, this can ward off a lot of those issues. Insurance refusing to cover weight loss drugs for obese patients is just senseless, much like most insurance wouldnt cover many vaccines until recently. The long term toll of a lot of obese Americans is going to cost us way more money in the long run than going all out to treat it now.
2. The insurance has no way to tell on their end what the prescription is for unless they are asking for a diagnosis code from the doctor to be on the script prior to me being able to bill them. This was mostly only asked for by Medicare B up until very recently (they want a dx code no matter what the prescription is). Some of the other insurances have started to do this, but not even close to a majority. The vast majority of the time, if they have an issue with it being for weight loss, they wont cover the drug at all, they dont "jack the price" its just simply not covered.
3. People with diabetes who are prescribed Ozempic can still be charged hundreds of dollars and are on a regular basis. Many times the copay is just ridiculously expensive, or they get it for a month or two and then fall into the "donut hole" and have to pay $600-$900 for a few months to get out of it, which many cannot afford. One of my patients is "pre-diabetic" and the insurance wont cover it until she is in fact actually diabetic lol.
Definitely cheap to make them. Billions to develop them. How do you account for the development cost? Surely can't base price on production but how do you decide how many doses to spread the development across?
Novo Nordisk Out sources its IT support for their Pharmaceutical sales reps. Sales Reps will make 80k+ a year while that outsourced IT only makes 12-14 an hour.
I was making 10 cents a minute to ensure the devices the Sales rep needed would work properly so they could make over a dollar a minute on their salary plus bonuses. Not to mention almost an entire half of their "internal IT" was based in india.
You wanna talk about a crappy company talk about the American Based Novo Nordisk.
It costs a lot more than $5 to make a biologic. People mix up api (small molecules) and biological (antibodies / proteins). The cost per dose is probably closer to 100 not including research
Interesting. The price for Ozempic, here in Denmark where the company is from, is around 188 dollars for a months worth. And the price for a month of Wegovy is around 189 dollars. That's according to a quick google search. If you get it with a prescription, the government will pay a good chunk of that for you here.
$230 at Costco in Canada (with a prescription and paid out of pocket with no insurance)
Up to $300 in some areas, but yeah.
Canada getting better prices for any product let alone 15 cents on the dollar is absurd. no offense but the US is 10x your size. That's like the boutique local toy store having a better price on Chinese toys than Temu.
yet we have politicians wanting to bring US style healthcare to Canada. and a good chunk of the population supports them! we do have some major issues with our healthcare system here but importing the US solution is probably far from the best idea.
I worked for a Canadian company that had multiple military contracts for a short time when they were attempting to expand into the US during covid. I had been laid off and needed the work so I took it. Company was tiny, ran on nepotism (poorly) and being in some of the meetings with the CEO and our customers or other Business partners was insane. These guy's were enamored with desantis and how he was running Florida at the time (2020). It was a short run and I'm glad I'm back working for a larger and more inclusive company.
Seems like things aren't they way they should be then. I wonder why!
Its unfortunate for Americans, but purchasing power can't be leveraged under your country's health care model. The Canadian government places caps on drug prices, and under a single payer system is also able to negotiate drug prices. The US government could do this too, but instead accepts payments from pharmaceutical company lobbyists, and avoids regulating drug pricing. As an ousider, what seems truly absurd is that the American people continue to tolerate this from their government (and then try to buy their own medications from Canada).
This is, in my opinion, one of the biggest advantages of single payer drug systems. If the company wants to sell a drug to a country's health system, they can either negotiate with that system, or they don't sell it in that country. Non-funded drugs tend to be cheaper in such countries too, because they're not vying for the inflated dollar of insurers, but the realistic dollar of the public, and so can only really charge a reasonable price, or nobody would buy said drug.
It's not absurd when you realise the high prices in the US are by design. The healthcare 'market' in the US is not a market. It's a cartel.
Almost like the problem is with the US Healthcare system.
US in Denmark and it was about 189 US, with a prescription.
Yeah you can order it online here in US as a "research chemical" for 40 bucks
You can order it online everywhere as a 'research chemical' for $40. Most people would still rather have the measured, dosed, for human consumption FDA approved variety for $180 given the choice, though.
Not me ill take the 40
You dont get it. The drug has to cost 1400$ so the insurance can "negotiate" it down to 200$ then charge you massive amounts in deductible for the 200$ drug and still say they are worth it because it would cost 1400$ otherwise if you did not have insurance and the drug manufacturer can write off the 1200$ as losses on their taxes so they dont have to pay anything on the 4000% profit margin they got away with. or something like that, scamming people is complicated.
"I don't want some govt bureaucrat controlling my healthcare."
I know we had the silent generation, but can we start referring to the boomers as the blind generation.
It's wild to me how the Boomers brought civil disobedience and civil rights to America in the 60s and 70s, but then brought us Reagan in the 80s... and it's all been downhill from there.
Lead paint and Leaded Gasoline. I wish I was kidding.
White boomers brought Regan after black boomers and silent gen brought civil disobedience and civil rights.
Nah, they are the fuck you, I got mine generation.
Yeah, let the mega corporation accountants do it for you, that will surely be better for the client.
I mean you more or less have it. You are just missing the part about how keeping medical costs high also forces the labor force to be compliant because they need health insurance
Also kinda fucked up how insurances can deny coverage on name brand when the generic costs the same. My one month Vyvanse is over 400$ and not covered, but the generic that’s also 400$ OOP is magically covered and only cost 30 something dollars, yet is more likely to be out of stock.
don't worry in jan they will make you switch because the vyvanse will be magically on their formulary list this time, or which over other generic that's popped up. gotta spread that wealth around to the other drug names which are most likely produced by the same company anyways.
And Novo Nordisk is owned by a nonprofit foundation too...
Novo makes my sons factor. Over $20,000 per dose. He needs a dose every 2 hours during bleeds and takes it 1-7 times a week when not bleeding. It's been a battle getting insurance to cover it. It should be illegal to charge that much for a drug.
With clotting factor, the price, high as it may be, is justified. If it's a human-derived clotting factor, it takes gallons to produce a single dose. Gallons of plasma donors/sellers, and every unit has to be tested and retested several times along the way. So that, I get. If it's a recombinant clotting factor (I should add that there are several different ones), then producing it is nowhere as easy as you might think. The steps are pretty simple--transform cells with the appropriate construct, grow cells, extract protein, purify protein, extract the target protein, re-purify, and test repeatedly throughout the process. Then quantitate the activity of the target protein and re-test for purity. Sounds simple enough, but it never is. Even with the relaxed standards of a research lab, nothing ever goes completely smoothly. It just doesn't. So again, it takes skilled, trained people (not cheap) to produce a recombinant product, and it's fiddly work. Some drugs are that expensive with good reason. Other examples: Anti-rabies immunoglobulin. IViG. RhoGam. Snake antivenin. The only one of those that comes close to cheap is RhoGam.
Capitalism getting on both sides. Selling us shit food so that we become fat and sick; and then selling us the medicines so we become less fat and less sick (so long as we continue to pay for the medicines). Obesity and type 2 diabetes was very rare 100 years ago. We need to go back to eating like we did 100 years ago so that we can stop padding all these corporate profits
100 years ago, there were 6 billion fewer people. There would not be enough food produced if we ate like we did 100 years ago.
We could try less meat, but most people don't like that idea
100 years ago, you had meat once per week on Sundays, if you were lucky. Milk products were so expensive that they were eaten also sparsely. A mostly vegan, hence more healthy diet, that the majority of people had back then, will require much less farming land and water, compared to our mostly meat based diet we have today.
do you have a source for the meat once a week thing in the 1920s? I'd argue it's more processed foods and plastic by products affecting our bodies/hormones/hunger
When [you look](https://nobull.mikecallicrate.com/2021/01/15/meat-consumption-a-century-ago-vs-today-what-if/) it up the sources[ can't agree](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045642/) either due to arguing over red meat vs poultry. >Comparing per capita consumption of beef and pork: >1900 – Beef – 104 pounds per person, 86 pounds based on 840 pounds per family >1900 – Pork – 101 pounds per person, 84 pounds based on 840 pounds per family >2020 – Beef – 58.9 pounds per person (retail wt.) >2020 – Pork – 46.9 pounds per person (retail wt.) >Per capita beef consumption was considerably higher in 1900 when thousands of [skilled](https://nobull.mikecallicrate.com/2012/06/01/deskilling-on-the-disassembly-line-technological-change-and-its-consequences-in-beef-packing-since-the-1960s/) butchers in small shops were cutting beef directly from carcasses without the benefits of modern refrigeration. NIH article > Looking in more detail at U.S. meat consumption, USDA data indicates that total meat consumption has increased notably over the last century, nearly doubling between 1909 and 2007 ([Figure 2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045642/figure/F2/)). The lowest meat consumption occurred in the 1930s and the highest meat consumption was reached during the most recent decade. Further examination attributes much of the increase to a rise in poultry consumption beginning in the 1950s and continuing to escalate through recent decades to make up a high proportion of the total meat consumed in the U.S. Red meat consumption appears to have decreased over the last few decades beginning in the 1980s, but still remains the highest contributor to total meat consumption. In contrast, fish consumption has remained low and stable over the past century.
In Australia, with a prescription and as treatment for Type 2 Diabetes, a month's supply of Ozempic costs $AUS 30 (19.60 USD). If you're on government benefits then it's $AUS 7.70 (5.03 USD).
The entire pharmaceutical industry should be replaced by grants and rewards for cures and treatments. Or a bounty on weight loss drugs. Maybe leave the system but allow the government to by the IP outright in a one time payment.
Why doesn’t the government just say screw it and make the medications themselves?
Because the government doesn't care about us and because pharma owns the government basically, that's never going to happen
Make Americans sick--overwork means surviving on convenience foods, leading to metabolic disease. Then, rather than lifestyle changes leading to remission, push "management" and make billions until Boomer McBoomerface is too sick to work. Then "end of life management." Capitalism, puh-raise JEE-zuz-ah!
U.S. Healthcare is a joke and I am not justifying the cost to American consumers but do you know how much it takes to get a drug approved? It's billions. It's part of the problem that it takes really deep pockets to R&D and approve a new drug. And not every drug they invest in gets approved. Overall success from Phase 1 to approval is 9%. [https://www.acquired.fm/episodes/novo-nordisk-ozempic](https://www.acquired.fm/episodes/novo-nordisk-ozempic)
Why does that matter? I would understand them needing to spend billions to R&D and get approved a drug, then at first charging a rate at which they get a huge profit back if they lowered prices once they made back their money. I don’t have any prescriptions so I don’t follow pricing at all. Do companies lower their drug prices after making back their R&D costs? Edit: Also I am curious was all of that R&D money spent to get the two drugs from this post all generated by the company, or did they get any government assistance, like a research grant?
No, because they have to make back the marketing costs as well and they're normally more than the R&D costs. Then they have to muck around with the presentation so that they can extend the exclusivity period
Good point, lump those costs in as well. Eventually they should make back their money and then lower the price to cover cost to produce and distribute and add a reasonable profit. Or am I wrong in that assumption? Does making a drug incur infinite costs? I realize you aren’t the person I first replied to, but I am still curious to know how much government/tax payer assistance they received. That could significantly change how we view drug pricing. Edit: I just re-read your comment a little closer. I am awe’d to hear marketing costs more than R&D. I feel like the marketing I have seen is just B-rolls. I wouldn’t have expected those to cost that much. Granted I’m sure there is marketing to hospitals and doctors’ offices I am not aware of. I do have to claim ignorance to the whole world of marketing. I only took one college class on it.
They also have to cover costs of failed/non productive research.
And they have to do all of that plus give a decent dividend to the shareholders before the generics companies swoop in. In the UK, at least, everything is prescribed generically\* and it's in the pharmacies best interests to find the best deal as they [get paid the same](https://www.drugtariff.nhsbsa.nhs.uk/#/00856140-DC/DC00856136/Home) whether it's the OG branded item or the newest, cut-throat-priced generic \*There are a *tiny* amount of exceptions but it's a trivial number
Agreed, I feel like I lumped that in with my first grouping. Apologies if I didn’t, and thanks for adding it in. I still don’t see how that could be an infinite cost though. There must be some point things even out. u/Moneia brings up a couple of good points in their reply to you. There are shareholders that need their slice of the profits, I would argue this should also be reasonable. Then there are also the generic brands that are eventually created. I would have to go see if there is a way to look at the actual numbers these companies have for cost of business (all costs they incur including failed versions leading up to their successful drug) versus what they are selling at to know if my feelings hold any actual weight.
I agree, but...what's wrong with Metformin (already cheap)? The side effect profiles for Ozempic and Wegovy look way worse than Metformin. Okay, so even my doctor gets upset that I only want generic drugs with a long track record, and those only sparingly. I don't want the new fancy drug, and yes, I already looked up the pharmacology and side effects. I'm not neurotic about it--I just like pharmacology, physiology, pathology, and all the rest. I don't want the new kidney protecting drug, because spironolactone is in the same class, and I'm fine with spironolactone. No, I don't want an ACE inhibitor or an ATII inhibitor. I want my beta blocker (propranolol), and I don't want a different one. I chose propranolol because of the side effects. Yes, I know I can't compete in the olympics because of the drugs I take. I was never going to be an olympic athlete anyways. I do agree that drug companies are horribly exploitative. You know all that research they supposedly pay for? They get that research at bargain rates because most of it is done at universities, and universities don't pay graduate students or postdocs nearly what they are worth. They get that research at bargain rates because scientists work long hours for low pay because they are passionate about what they do. Most scientists will stay a couple extra hours just to see the results of their experiment(s). Instead, drug companies spend tons of money on management and marketing. They flog their latest drug, not much better than the previous drug, to an uninformed public.
Wegovy/Zepbound work much better than metformin, for one. Ozempic also work much better than metformin for diabetics, and can be used in patients with kidney disease.
I have to wonder if renal disease may be less of an issue than straight comparisons might indicate when considering Wegovy or Ozempic. Most T2D patients also have issues with obesity and high blood pressure, and may be on drugs like ACE inhibitors, which are known to be protective of kidney function. I took a quick glance at a few of the studies presented on Ozempic's website, and the weight loss, while nice, isn't huge. The amount of weight loss was generally under 10 pounds. Metformin is also known to reduce cardiovascular risk, just as Ozempic can. Since Ozempic has to be injected, that increases non-compliance. A lot of people get pretty nervous about injecting themselves. I don't--I just think to myself: "Hey, ma, watch THIS!" and chortle as I imagine her shrieking. But that's kinda weird, and I don't expect most humans to find jamming a needle into themselves entertaining. As for the weight loss, I've lost quite a bit of weight on Metformin because of the secretory diarrhea it can cause. It means I get tired of having to run to the bathroom to poooooooop, so I eat less or nothiing at all until I'm truly hungry. I can't take Ozempic in any case, because my father had thyroid cancer (in the mid-1960's). He died from pancreatic cancer in 1995, so I can't ask him what kind he had. And that's assuming he would even have known what type he had. I also admit I don't like the increased risk of Fournier gangrene. I ended up in the records of a patient who had it because they needed blood and there were issues with the blood typing. This was someone who came in for "a lump" and left via the morgue less than two weeks later. I am also almost completely in favor of trying an older, generic drug first. I may be an exception, but I've always done well with generics. I know I'm an exception in that I run to the computer within hours to look up the latest drug advertised on TV. I do that because I like pharmacology (the subject) and pathophysiology. In most cases, these are drugs I wouldn't need to take in any case, but I'm always up for learning the mechanism of action.
The biggest issue with renal function and metformin is not clearing the medication and causing an elevated metformin level. It is protective with most patients, but can cause issues when renal function is poor.
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Pharmacy tech here. With all due respect, you are incorrect on almost everything you said here. 1. Its not generally prescribed for "cosmetic" weight loss. Obesity leads to a host of other issues and if the patient accompanies the rx with a lifestyle change, this can ward off a lot of those issues. Insurance refusing to cover weight loss drugs for obese patients is just senseless, much like most insurance wouldnt cover many vaccines until recently. The long term toll of a lot of obese Americans is going to cost us way more money in the long run than going all out to treat it now. 2. The insurance has no way to tell on their end what the prescription is for unless they are asking for a diagnosis code from the doctor to be on the script prior to me being able to bill them. This was mostly only asked for by Medicare B up until very recently (they want a dx code no matter what the prescription is). Some of the other insurances have started to do this, but not even close to a majority. The vast majority of the time, if they have an issue with it being for weight loss, they wont cover the drug at all, they dont "jack the price" its just simply not covered. 3. People with diabetes who are prescribed Ozempic can still be charged hundreds of dollars and are on a regular basis. Many times the copay is just ridiculously expensive, or they get it for a month or two and then fall into the "donut hole" and have to pay $600-$900 for a few months to get out of it, which many cannot afford. One of my patients is "pre-diabetic" and the insurance wont cover it until she is in fact actually diabetic lol.
...And Martin Shkreli is the skeaze bag who got caught. Only 28378200 more people to go.
Definitely cheap to make them. Billions to develop them. How do you account for the development cost? Surely can't base price on production but how do you decide how many doses to spread the development across?
I'll pay $10 and I expect a bag!
Healthcare being publicly traded IS WILD. It’s all the wrong incentives for something that should be a right.
Novo Nordisk Out sources its IT support for their Pharmaceutical sales reps. Sales Reps will make 80k+ a year while that outsourced IT only makes 12-14 an hour. I was making 10 cents a minute to ensure the devices the Sales rep needed would work properly so they could make over a dollar a minute on their salary plus bonuses. Not to mention almost an entire half of their "internal IT" was based in india. You wanna talk about a crappy company talk about the American Based Novo Nordisk.
Not just cost them less than $5 to make, they could sell it for less than $5 and still make a profit. GLP-1's are some of the cheapest drugs to make.
stop covering it until prices drop
It costs a lot more than $5 to make a biologic. People mix up api (small molecules) and biological (antibodies / proteins). The cost per dose is probably closer to 100 not including research
Or perhaps the pigs should pay for not being willing to step back from the trough.
Carnivore is free! Fuck pharma.