ResearchSafe

Weight loss injections are making obesity a wealth problem

Posted by sky323 in Weight Loss & Metabolic - 2 points, 6 comments.

https://www.bbc.com/news/articles/cre5xp83394o

BBC piece on how GLP-1 access is splitting by income, since a lot of people end up paying out of pocket while obesity rates are way higher in poorer areas. NHS data backs this up, so it is not just hand-waving.

The part that stuck with me is how much of this is a supply and pricing story, not just a willpower story. If the actual demand is concentrated where the money is not, then shortages and pricing are basically a built-in feature right now. Fwiw, my own n of one numbers on food intake dropped fast when I titrated up, so I buy the demand curve shifting, the question is just who gets to ride it.

Curious how others here think this plays out long term, do you see pricing coming down once the patent window opens, or do the newer dual agonists just keep the same gatekeeping going?

Comments

  • sanjay_j602: Honestly the pricing angle is what keeps me up on this one, lah. Patent cliff might bring the price down a bit but if the newer dual agonists keep getting approved and prescribed, insurance just keeps paying for whichever one is newest and patent-protected, so the old cheap one never really becomes the default. Pharma has done this trick before with biologics and insulin, so I wouldn't hold my breath for a real race to the bottom. The intake drop thing tracks for me too, it was wild how fast my
  • paul_labrat: Yeah the biologic pattern is exactly what worries me too, fwiw. Insulin is the obvious one, same playbook over and over. The appetite quieting thing was almost scary for me honestly, one day I just forgot to eat lunch and only realised at 4pm 😅
  • nerdydiego: Yeah the pricing curve never really resets the way people hope, does it... And the dual agonist point is spot on, each new one just resets the patent clock while the older compound lingers at a price that still keeps it out of reach for the groups who actually need it most. Same trick as insulin, exactly. I reckon the supply side only ever follows the money, not the need.
  • sky323: The insulin parallel is exactly the one I keep coming back to, fwiw, because you can actually trace the generic uptake on that one and it is still messier than the theory suggests it should be, like the 90s generics did drive some price relief for a while but then the analog shift just reset everything. I do wonder if the GLP-1 space has enough payer diversity right now that the squeeze plays out differently, like the PBM side is more fragmented than it was with insulin, but that might just be w
  • sky323: The 4pm thing hits different though, like you really do have to consciously eat instead of just following hunger, at least for me it was that way for the first few weeks. I was logging meals and kept having to set actual reminders, my natural eating cues just went quiet so fast it felt almost uncanny. The insulin parallel is solid too, same generics pipeline problems, same patent evergreening, the dual agonist stuff especially feels like the next chapter of exactly that playbook.
  • sky323: That insulin point is a fair call, fwiw i was hoping for something more like the generic shift we saw with older statins but the biologics comparison makes more sense, it feels like they just move the goalposts to a new molecule before the old one gets cheap. I remember my appetite just vanishing during that titration phase and it felt like a switch flipped, but if the cost stays this high then that switch is only for people with the right insurance.

Community discussion - research and educational context only. Not medical advice.