Bridge. Landscape from Four Points of View

If Wegovy Is a “Game Changer,” What Comes Next?

The mantra for the Wegovy brand of semaglutide just approved by FDA for obesity is clear enough – game changer. Great. Obesity is not a game, but health plans treat it like a 19th century game of hot potato:

“Jack’s alive, and likely to live
If he dies in your hand, you’ve a forfeit to give.”

In short, everyone in the healthcare system dodges responsibility for obesity care. So if Wegovy is a “Game Changer,” we say bring it on. However, this is just the start of changes that will continue for a while. So what comes next?

Pricing and Access

Let’s be frank. Obesity is a common problem that takes a huge toll on health. But obesity care is so rarely delivered that the only way for an innovative anti-obesity medicine to be successful was a high price. Thus, the list price of Saxenda – the predecessor of Wegovy – is $1,297.13 per month.

Healthcare providers use anti-obesity meds as if they are specialty pharmaceuticals, exotic drugs to be used only rarely. But specialty pharmaceuticals come with a high price tab. The average is $4,500 per month. So in that league, Saxenda has a low price.

Novo Nordisk says they will price Wegovy to be comparable to Saxenda, which sounds good. A much better product without a price premium.

Care Is Rare for This Common Disease

However, we can’t lose sight of a basic fact. Obesity is not a rare condition. Access to care is rare, but the disease is common. The reasons are many, but one big part of it is that the tools for treatment have been too limited. If Wegovy is a game changer, treatment will have to become more common. If treatment becomes more common, the pricing model will have to change.

For comparison, Jardiance is a pricey, but cost-effective, drug for diabetes. Its list price is $548.54 per month. Expensive, but less than half the cost of Saxenda and presumably Wegovy. The pricing model is lower for diabetes because more patients get treated and more health plans cover the treatment.

Innovation and Competition

More innovation will come beyond Wegovy. Tirzepatide will be going to FDA this year for approval in type-2 diabetes. An obesity indication will come some time after that. Its profile seems to be competitive with semaglutide. But the dosing may be the same for both obesity and diabetes. If so, tirzepatide will put downward pressure on innovative obesity drugs.

The other innovation coming is an oral form of semaglutide for obesity. The pivotal clinical studies for this have only just started, so marketing approval is likely three years away. Other, even more innovative drugs are in the works.

Clearly, big changes lie ahead for obesity care. Access and the options for care seem likely to improve. That’s good, because Wegovy will be a game changer only if it reaches enough of the people who can benefit from it.

For more on innovation in anti-obesity meds, click here.

Bridge. Landscape from Four Points of View. Painting in the futurism style by David Burliuk / WikiArt

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June 8, 2021