Amid Skyrocketing Demand, Insurers And PBMs Limit Weight Loss Drugs
With soaring demand for weight loss drugs like Ozempic and Wegovy, the Wall Street Journal says officials are moving to restrict access to some of today's "buzzy drugs." Some pharmacies are even offering unauthorized Ozempic alternatives.
Modern Healthcare:
Insurers, PBMs Restrict Access To Weight Loss Drugs As Demand Soars
When Tim Norfleet heard the Ohio Department of Education would pay for its workers to use anti-obesity drugs, he knew he wanted to sign up. Norfleet, 61, a federal programs specialist, said he had been mulling undergoing weight loss surgery after gaining 50 pounds since the start of the COVID-19 pandemic and using a drug, combined with exercise and diet changes, seemed preferable to surgery. (Tepper, 5/16)
The Wall Street Journal:
How To Get Your Health Insurance To Cover Ozempic And Other Drugs Used For Weight Loss
If you want to take one of the buzzy drugs like Ozempic or Wegovy to lose weight, the toughest part may be finding a way to pay for it. Insurers and employers, fearing the cost of medications that list for $900 or more a month, often put up hurdles when patients seek access to one of the drugs to slim down. Yet there are ways to get your health plan to pay for your prescription, if you qualify—and some alternatives if you don’t. (Mathews and Loftus, 5/15)
The New York Times:
Some Pharmacies Are Offering Unauthorized Ozempic Alternatives
When Carrie Davis found out that her health insurance wouldn’t cover Ozempic, she sought an alternate route to getting the diabetes drug, which is increasingly being used off-label for weight loss. Ms. Davis, 55, did not have diabetes, but had gained 50 pounds during menopause and developed hypothyroidism, she said, and was eager to lose weight. After seeing someone claiming to be a doctor on TikTok saying he could help patients obtain a generic version of the medication, she reached out. After a few days and a brief video consultation with someone who introduced herself as a nurse practitioner, Ms. Davis had a prescription in hand. “It was really fast,” Ms. Davis said. (Blum, 5/16)
In other pharmaceutical news —
The New York Times:
Drug Shortages Near An All-Time High, Leading To Rationing
Thousands of patients are facing delays in getting treatments for cancer and other life-threatening diseases, with drug shortages in the United States approaching record levels. Hospitals are scouring shelves for supplies of a drug that reverses lead poisoning and for a sterile fluid needed to stop the heart for bypass surgery. Some antibiotics are still scarce following the winter flu season when doctors and patients frantically chased medicines for ailments like strep throat. Even children’s Tylenol was hard to find. (Jewett, 5/17)
NPR:
Families Scramble To Find Growth Hormone Drug As Shortage Drags On
Eddie held up Bryan the Lion, a stuffed animal with its very own tiny plush injector pen and little blue stars stitched onto its fuzzy body." The stars are where we do the shots," his dad said, prompting his 4-year-old son to chime in. "Yeah! Um, this is the pen," Eddie said, as he gave the lion a few faux shots. The toy was a gift from Novo Nordisk, the Danish pharmaceutical company that makes Norditropin, an injectable human growth hormone drug for kids like Eddie whose bodies don't make enough of the hormone they need to grow. (Lupkin, 5/15)
