Elusive Billions for Obesity Care

A recent headline in Wired shouted it out: “Diabetes drug that also treats obesity could make billions.” What followed was a mostly reasonable discussion of the risks and benefits of obesity treatment in the jocular tone typical of Wired. Alexa Kurzius explains her assessment of the potential for Saxenda (liraglutide) for obesity:

Initially, weight loss was just a side effect observed in liraglutide research. But there are good reasons to use the drug to attack a weight problem before it becomes diabetes—a process that takes time as your body becomes resistant to insulin. In 2012, the United States healthcare system spent $245 billion dollars on diabetes. Some researchers estimate this cost could rise to $512 billion by 2021. Effective weight-loss drugs could help stem that bleed.

Financial results released Friday by Saxenda’s maker, Novo Nordisk, helps to bring a dose of reality to that forecast of “billions.” In the first quarter of 2016, the Saxenda’s sales totaled a little less than $40 million. That’s well ahead of modest expectations and substantially higher than the rate of sales for its closest competitor.

Utilization is growing, but not as rapidly as the utilization of new diabetes drugs. There’s a long way to go before sales amount to the “billions” predicted by Wired.

Countless other observers have made the same mistake over the years. They fundamentally misunderstand the challenge of meeting the considerable need for more and better obesity care. Sadly, the many systematic impediments to delivering that care are slow to break down.

Bias is fading, but slowly. The numbers of healthcare professionals who are prepared to treat obesity are growing, but they are still far too few. Both health plans and the people who pay for them are slowly figuring out that they had better start paying for good obesity care. They are beginning to realize they can’t afford the bills resulting from the chronic diseases that follow when they don’t.

So it will take some time before sales of an obesity medicine reach the “billions” that Wired predicts. For now, the healthcare system is focused on spending hundreds of billions on the complications of untreated obesity. Progress is slow, but it’s coming.

Click here to read more from Wired. Click here and here for more on Saxenda’s performance.

Hidden Treasure, photograph © Niks Freimanis / flickr

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Month 00, 2016