Final week, Vermont Senator Bernie Sanders pressed the chief govt officer of Novo Nordisk to decrease costs of in style weight-loss medication comparable to semaglutide – marketed in the US as Wegovy and Ozempic. The September 24th listening to many Individuals at the moment fighting the excessive price of acquiring these medication to assist their very own weight reduction journeys. Senator Sanders’ advocacy is welcome, however some could not understand that his effort to carry Novo Nordisk accountable additionally helped advance the care of these fighting psychological sickness and dependancy.
The recognition of semaglutide and different glucagon-like peptide-1 (GLP-1) agonists that promote weight reduction can’t be underestimated. A 2022 research in Nature demonstrated a imply lower of 15.2% of physique weight throughout 104 weeks of follow-up amongst customers of semaglutide in comparison with solely a 2.6% discount in weight among the many placebo group. For a lot of Individuals who’ve both had no success with way of life modifications or seen their weight reduction journeys flip stagnant, Wegovy and Ozempic provide life-changing hope and promise.
Sufferers with schizophrenia have almost 5 instances the prevalence of diabetes and weight problems compared to others within the basic inhabitants. Weight acquire typically accompanies pharmacological therapy of schizophrenia, which additional compounds the issue. Nonadherence to therapy regularly outcomes, resulting in psychological well being decompensation. Lately, research analyzing the usage of semaglutide and different (GLP-1) agonists (e.g., luraglutide) have demonstrated these brokers are efficient in limiting antipsychotic-induced weight acquire. These findings have important import for sufferers on antipsychotic remedy who could in any other case not search care due to worries about weight acquire.
The potential good thing about GLP-1 agonists in psychological well being care could additional lengthen past their utility in weight reduction. A Might 2024 research in Nature of over 80,000 sufferers with weight problems confirmed that semaglutide utilization was related to a 50-56% decrease threat for incidence and recurrence of alcohol use dysfunction over a one-year follow-up. Analysis additionally means that GLP-1 agonists could lower nicotine cravings. People who stop smoking sometimes acquire 8-11 kilos in the course of the first six months following an try and stop, a typical sufficient concern that dissuades some from making an attempt to cease in any respect. GLP-1 agonists that each promote weight reduction whereas lowering tobacco use have important potential to catalyze tobacco cessation makes an attempt, resulting in greater stop charges and decrease tobacco-associated medical comorbidities comparable to heart problems and most cancers.
Vital value disparities for pharmaceuticals are sometimes the norm moderately than the exception in the US. Within the Senate listening to in late September famous above, the price of Ozempic was cited as 9 instances costlier in the US ($969) than in Germany ($59). Present US pricing of Wegovy at $1,349 far surpasses the price of the identical drug in Denmark ($186) and makes buying this remedy out of attain for a lot of.
After all, the recognition and efficacy of GLP-1 agonists for weight reduction should be balanced in opposition to threat of recognized unintended effects. Gastrointestinal misery, together with nausea, vomiting, and acute pancreatitis is extra frequent with use of GLP-1 agonists. In December 2023, the US Meals and Drug Administration’s Antagonistic Occasions Reporting System noticed a disproportionate improve in suicidal ideation with GLP-1 agonists, though no corresponding rise in suicidal conduct, makes an attempt, or accomplished suicides was famous. The speed of incidence of those unintended effects was low, however extra widespread use of GLP-1 agonists within the basic inhabitants implies that these opposed results will probably be extra seen.
GLP-1 agonists characterize a turning level within the pharmacological therapy of weight problems. Their potential profit and attain could nicely lengthen past weight problems. Nevertheless, reputation and desirability mustn’t eclipse the necessity for due diligence and additional investigation. Scientific equipoise should dictate the long run position of GLP-1 agonists within the therapy of different medical and psychiatric circumstances. Ought to future research on these brokers be encouraging, the chance for significant and consequential influence on the nation’s public well being shouldn’t be overshadowed by value gouging and economics. Drug producers ought to know that buyers – and Congress – are watching intently.
