Senator launches new models to manage costs of weight-loss drugs like Ozempic

WASHINGTON With blockbuster sales of Novo Nordisks Wegovy and Ozempic and the approval of a new rival this week, everyone in Washington is thinking about how to deal with the surging tide of weight-loss drug costs.

Explosive national demand for weight management therapies and diabetes drugs like Ozempic, all of which are indicated for indefinite use, has become central to an ongoing political debate over high drug costs and controversial tactics for managing them. , including President Biden’s plan to let the government negotiate directly. with pharmaceutical companies. Seventy percent of Americans could benefit from these medications.

Sen. Bill Cassidy (R-La.), the ranking Republican on the Senate Health Policy Committee, vehemently opposed the negotiating plan, arguing that it reduces incentives for the development of new therapies and may not actually reduce costs for patients.

The longtime doctor raised another possibility, at least for blockbuster obesity drugs: Federal agencies could take the lead in researching ways to stop the drugs.

Cassidy spoke recently with an economist who suggested that the National Institutes of Health should develop sponsored studies in which [a patient] would have a treatment lasting a year, and then you would replace Ozempic with a dietary therapy like meal delivery, he said at the Milken Summit on the Future of Health.

The senator and various economists have warned that it is simply not cost-effective for federal health programs and commercial insurers to pay for lifelong use of weight-loss therapies. Ozempic costs around $11,000 per year, while Wegovy’s list price is around $16,000. Eli Lilly will sell Zepbound, the latest obesity therapy approved by the Food and Drug Administration, on Wednesday at a list price of $1,059.87 per month.

For now, however, Medicare is not allowed to pay for this class of drugs. Cassidy and other lawmakers from both parties have introduced legislation to authorize coverage of the federal program, which could open the door to more than 60 million Americans.

Novo and Lilly conducted numerous analyzes conveying the message that their therapies, by reducing rates of diabetes and heart disease, would save money in the long term, making the price attractive to society. But many independent studies have not concluded that these treatments are cost-effective. A recent analysis by University of Chicago researchers found that even with a 75% discount, Wegovy would not be cost-effective for lifetime use.

Novo also hired a lobbying firm this year to push for Medicare coverage.

We know empirically that some will do well with limited use and others won’t, Cassidy acknowledged. But even if a number of people in the study return to weight-loss drugs, costs will be better managed, he argued.

The senator stressed during the panel that there would be no one-size-fits-all approach to cutting costs, including Biden’s negotiating plan. When it comes to medication costs, there is no silver bullet. So there is silver buckshot.

Still, a limited-use study could provide a new call for NIH to take a more active role in the drug pricing conversation. Cassidy’s comments came the same day Monica Bertagnolli assumes the role of director, after the Senate confirmed her to the position this week.

Cassidy’s colleague Bernie Sanders, president of HELP, blocked his nomination and ultimately voted against his confirmation because Bertagnolli would not commit to requiring drugmakers who use NIH research to set a reasonable price for the resulting medications. Cassidy opposes the so-called reasonable price provision favored by Sanders and also criticized the committee chairmen’s approach to pharmaceutical companies on Wednesday.

Senator Sanders is not in favor of the profit motive in medicine and believes that much of this innovation would take place without the profit motive, he said. I’m not giving companies carte blanche, they will push the limits on what they can charge on. But we also need to be aware of the powerful impact on innovation, and I want to make sure we preserve that incentive.

Elaine Chen and Damian Garde contributed to this report.