The Wrestlers

Tirzepatide Approved for Obesity: Will Competition Help?

Zepbound Injection PenIn an era of tremendous change for obesity care, this is certainly a huge milestone. FDA approved tirzepatide for obesity treatment yesterday and put Lilly in the position to offer serious competition to Novo Nordisk. But the question that matters most to us is simple. How will this competition help people seeking to cope with the chronic disease of obesity?

The Really Good News

The good part of this news is quite obvious. Tirzepatide, which will sell for obesity under the brand name of Zepbound, is highly effective. In fact, as obesity medicine physician Fatima Cody Stanford told the Associated Press:

“This would be the most highly efficacious drug ever approved for the treatment of obesity.”

No, it’s not a miracle drug. It is the product of decades of research – with many trials and errors. Like any prescription drug, it can have serious, even life-threatening, side effects. But when used with care and carefully monitored by a healthcare professional it can be life-changing.

Kelly Burns, a patient in one the trials that led to tirzepatide’s approval, told the AP’s JoNel Aleccia that she intends to stick with this treatment:

“My whole life is completely different. It would be ridiculous not to. I want to stay this way as long as I possibly can.”

Helpful Competition

Apart from the obvious benefits of a more effective treatment option, we expect to see some benefits from competition. Signs of this are already appearing. For one thing, even though the effectiveness appears to be better for tirzepatide, the list price is coming in at $1,060 per month – about 20 percent less than the price for semaglutide under the brand name of Wegovy for obesity.

No, it’s not a bargain basement price. But the fact that Lilly highlighted the list price in this announcement suggests that we might see some price competition. List prices are nothing but the tip of the iceberg.

Just as important is the competition to meet patient needs in other ways. At the top of our list is providing a more reliable supply. Novo Nordisk’s track record has not been especially good. Semaglutide is still in a shortage situation two years after approval for obesity and six years after its first approval for diabetes.

It has not been totally smooth sailing with the supply of tirzepatide, but right now, all dosage forms are listed as fully available. Lilly expresses a commitment having “all hands on deck” to meet the demand. Novo Nordisk is not so bold in their commitment to meeting demand, saying only that they are “gradually” expanding their supply and can’t really say when the shortages will end.

Affordability and Patient Assistance

Another sore point has been access to care and patient assistance. Costs are high and insurance coverage of medicines for obesity has been spotty at best. In the approval announcement for tirzepatide in obesity, Lilly described specific programs to help patients to afford the out-of-pocket costs their medicine might entail. If this signals that the companies may compete to make their medicines affordable, this would be quite welcome.

A Duopoly for Now

So now we have a duopoly in advanced obesity medicines. You can expect some measure of added competition. Down the road, additional competitors may add even better options and bring more competition to further benefit consumers.

We are hopeful.

Click here, here, here, and here for more news of this important milestone.

The Wrestlers, painting by George Luks / WikiArt

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November 9, 2023