Let’s Check the Scorecard on Our 2024 Predictions

This year is rapidly winding down and already, our gaze is shifting toward expectations for the coming year. So before that shift is complete and we start making predictions for 2025, let’s check the scorecard for the expectations we had for 2024.

A year ago, we put forward predictions of five hot topics for the year ahead and five that would leave us cold. Starting with ones we thought would be hot, here’s an accounting.

✅Pricing

We had this subject at the top of our hot list and it was indeed hot throughout the year. Price has been a big barrier to the utilization of obesity medicines – with many health insurance plans dropping coverage because of it. The CEO of Novo Nordisk faced an intense grilling in the Senate about pricing of Wegovy and Ozempic. Lilly made a bold move to drop the list price of Zepbound by half for patients paying cash to get ahead of the issue.

Yes, drug pricing was a hot topic throughout 2024.

✅Access

Closely tied to pricing was the contentious issue of access to care. But it is also an issue of scale for health systems to deliver obesity care that people now want and need. It is lacking, and thus, access to care is limited and inequitable.

✅Telehealth

Rounding out a trio of hot topics that traveled in parallel is the trend for delivering obesity care through telehealth providers. The space became quite crowded because of the need for better access and the opportunities it created. Even Lilly got into this business – an unusual move for a big, conservative pharmaceutical company.

✅Competition

Competition in the market for obesity medicines was hot this year in two forms. Pharmaceutical companies jostled through the year to claim bragging rights for progress on the next big thing in research and development. Stock prices soared and tanked on the tiniest scraps of data from clinical trials.

Then there was the competitive pressure from compounding pharmacies and telehealth organizations selling compounded versions of semaglutide and tirzepatide. It was uncomfortable and unusual competition for two patent-protected pharmaceuticals.

✅Pediatrics

Growth in the utilization of medical obesity care for young persons continued steadily throughout 2024. It was less contentious than it had been when a new guideline for pediatric obesity care emerged in 2023. But that is largely because people are getting down to the serious business of figuring out how to deliver it.

✅Paternalism

Paternalism was on our not hot list for 2024 and the rejection of we-know-what’s-best-for-you surfaced in many ways. Cautions about the risks of compounded drugs fell on deaf ears. We even have a nominee to head Health and Human Services who doesn’t much like advice for vaccinations. Nope, the public mood about paternalism is not favorable.

✅HAES

We supposed that the Health At Every Size movement would lose traction as people are finding advanced obesity medicines to be life-changing in a very positive way. HAES has certainly not disappeared and many of the movement’s issues about weight stigma are as valid as ever. But a quick look at Google Trends will tell you that HAES does not resonate as it once did.

✅Artificial Intelligence

At the beginning of the year, cynicism about AI was pretty high. We predicted an end to preoccupation with doomsday scenarios about this technology. Instead, we said that although it might not take over the world, AI surely would quietly infiltrate healthcare and medical research. This continues to be true.

❌Compounding

Boy, did we get this wrong. At the beginning of 2024, we wrote:

“We expect that, as competition prods Novo to do better, the opening for compounders will close.”

The year is done, semaglutide from Novo Nordisk is still in shortage, and compounders continue doing a big business.

❌PBMs

This might have been wishful thinking. Our 2024 predictions said that for PBMs, “their prime years of profiteering may have past.” Though these businesses have gotten lots of static in 2024, they are still sucking money out of healthcare budgets, unimpeded by any major reforms.

You Be the Judge

In our way of thinking we were on the mark with eight of ten predictions for 2024. But take a look at the original list here and decide for yourself.

Saint John Church of Sohrol, photograph by Farzin Izaddoust, licensed under CC BY-SA 4.0

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December 30, 2024