Compounded Obesity Medicines Signal Distress

This is a problem of human mistakes. Compounding pharmacies are exploiting the failure of pharmaceutical companies to meet the scale of need for effective obesity medicines. So people with a serious medical need for these medicines face a hideous choice. Suffer without them or take a chance on dodgy compounded products. The fact that this choice is commonplace is a signal of distress in healthcare for the most prevalent chronic disease in the world – obesity.

We are not coping well with the scale of this health problem.

Little Assurance of Safety

A recent publication in the American Journal of Emergency Medicine sums up the problem:

“Due to the current shortage and expense of these medications, many patients have attempted to obtain these medications from non-licensed and unregulated agents, which may be associated with increased risk of serious complications.

“There are no means of verifying the effectiveness or safety of compounded medications.”

Despite the risks, failures of our healthcare systems are leading some people to take their chances with compounded obesity medicines. NPR tells the story of one such person who gave it a try because she had no other options. Pharmaceuticals reporter Sydney Lupkin sum up the problem:

“Although it’s safest to get FDA-approved, brand-name drugs through your regular doctor and pharmacy, the high prices, spotty insurance coverage, and limited availability have driven many patients elsewhere.”

Plenty of Blame

Obesity care should not require people to roll the dice with their health. But this is very much the case right now and there’s plenty of blame to go around. The supply from FDA-regulated manufacturers is unreliable. Even people who have coverage find themselves stretching out their doses and suffering ill effects because of that. All because the supply is poor.

Then, too, the list prices that people without insurance have to pay are too high. The companies that set those high list prices point to declining net prices – but that means nothing to a consumer who must pay out of pocket – like the Ohio seamstress, Jennie Smith, whom NPR profiled. She would have had to pay the inflated list price. Abusive practices of health insurers add to the problem.

List prices are inflated because pharmacy benefit managers control access to these drugs. A high list price leaves room for discounts that pad their profits. Drug pricing is seriously screwed up on the U.S. The result is that we pay the highest prices in the world for our drugs.

And of course, compounding pharmacies get plenty of the blame, too. Those that produce a poor quality product are obviously at fault. But the bigger problem is a lack of robust regulation and transparency that might give patients a better shot at getting a high quality product.

Problem Solving Please

We have no doubt that these problems will clear up – eventually. But the explosion of compounded obesity medicines is a signal of distress. Everyone who is a part of this mess should be acting urgently to resolve it. We need a solid supply, pricing reform, better insurance coverage, and more robust, transparent regulation of compounding pharmacies. There’s no excuse for delay.

Click here for the report from NPR and here for the report from the American Journal of Emergency Medicine.

The Signal, painting by Henri Le Fauconnier / WikiArt

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June 1, 2024