The Gap in Patient Assistance for Obesity Medicines
Recently, Novo Nordisk CEO Lars Fruergaard Jørgensen did a rare interview with NBC News to talk about the high price of obesity medicines that are proving to be so important for so many people. It seemed like a dress rehearsal for his coming appearance at a Senate hearing on the subject. He brought up the subject of patient assistance programs as a help for persons with obesity who can’t afford these pricey medicines. Jørgensen said:
“I do acknowledge that some patients have poor insurance. And if you have poor insurance, it can be difficult to afford your medicines. And for those we have patient support programs where we try to help them out.”
Not a Winning Argument
This might not be a good argument to advance in the coming Senate hearing.
The reason is simple. For reasons we have trouble comprehending, both Novo Nordisk and Eli Lilly have excluded their obesity medicines from the patient assistance programs they offer. We hear from people in these companies who find themselves embarrassed by this exclusion. But there it is. If you need their drugs for obesity and have no money to pay for it, you’re out of luck.
Patient Assistance – Unless You Have Obesity
These companies are made up of people who, more often than not, chose careers that would help people. And, by and large, patient assistance programs are a tool for helping people. Novo Nordisk has a patient assistance program that provides Ozempic at no cost to patients living in poverty. But if you need the same drug (semaglutide) in the form of Wegovy for obesity, you’re out of luck.
For Lilly’s tirzepatide, the gap in patient assistance is even bigger. Because neither Mounjaro (for diabetes) nor Zepbound (for obesity) is covered in the Lilly Cares program for assisting people in poverty with access to important medicines.
Why?
Honestly, we cannot find a good reason for this appalling gap. These are companies of people who want to do good in the world and improve human health. They are making earnest efforts to erase the stigma attached to obesity. Maybe, as some have speculated, they’re doing it to put pressure on payers for better coverage.
Yet with these discriminatory policies for patient assistance in obesity, they are complicit in perpetuating stigma. Kody Kinsley, North Carolina’s Secretary of Health and Human Services, recently described the role of stigma in coverage exclusions. Speaking in the context of Medicaid coverage for obesity medicines, he said:
“We only have conversations about not covering certain drugs when they’re related to stigmatized illnesses, whether that be HIV medication, or treatment for opioid use disorder.
“The most expensive drug for me in my program is primarily prescribed for eczema. The cost for that will be almost twice what I will pay for weight loss. And nobody is complaining about the cost of eczema.”
North Carolina made the decision to cover obesity medicines under Medicaid. “Morally, it is just the right thing to do,” said Kinsley. We wonder if Novo Nordisk and Lilly can reach the same conclusion for their patient assistance programs.
Click here, here, and here for more on the glaring issue of disparities in access and pricing for obesity medicines. For more on the pitfalls of pharmaceutical patient assistance programs, this paper is worth a read.
Horns Hole, painting by Tom Scott / WikiArt
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September 7, 2024
