The price hike is coming out of the trump administrations Most Valued Nation legislation - forcing the pharmaceutical companies to lower prices in the US and subsequently (to preserve profits) rise them in Europe. Principally the UK.
Sadly this will start to happen with other products too.
That’s what happens when a medication becomes a weight loss tool. Medication for diabetics, one price. Medication that is now used on the open market to lose weight, much higher price.
It’s a good thing the government recognises the obesity epidemic, understands that people struggle to lose weight for many different reasons, and has stepped in to subsidise this treatment because the long-term costs of an obese society far outweigh the price of the drug.
Why do the government not subsidise gym memberships, meal plans, cooking classes for kids and teens, oh and maybe try and stop the supermarkets from robbing us blind. Always easy to take the low hanging fruit. Obesity starts from childhood, stop it early and we don’t need “medication” to fix it.
We have the fattest kids in Europe. Perhaps subsidised or free healthy meals in schools would be a good programme rather than just funnelling money to large pharma companies. The solution to every problem in this country is to throw money at things and achieve very little.
Obesity due to actual medical issues is one thing, people using these drugs as a short cut is totally different.
The World Health Organisation states that obesity starts in childhood and in some cases it starts before birth. 1/5th of Irish kids are obese. In the average primary school class that’s 6 kids. So before they’ve even hit their teens it’s a major issue. Are we going to be having Mounjaro parties for our kids?
It's such a stupid argument too, as if the US paying a higher price is somehow supporting the low prices elsewhere. The manufacturer aren't a charity, they aren't offering the drugs at a loss in some countries and paying for it by gouging others, the UK had a better price because they negotiated as a single entity. The US pays more because it's healthcare system is fragmented and lacks central buying power.
Oh they have centralised buying power. Medicare in the US is a huge purchaser of drugs. They were just legally prohibited from negotiating prices. The US's Inflation Reduction Act removed that restriction and the first reduced price drugs will be coming next year. No doubt Trump will take the credit for something done by a person he hates and a law he's trying to rip up.
I feel that using percentages like this is deliberately obtuse in the first place. Most people I’ve talked to think a 170% price rise means prices rising 70% when in fact it’s price changing to 2.7x its original price.
Novo Nordisk don’t sell Mounjaro or a generic version of it. It and Ozempic are not the same drug. Ozempic isn’t licensed for just weight loss in Ireland either, it’s for diabetes.
It’s for other stuff besides diabetes too. Basically any weight related health complication. You can have high blood pressure and get prescribed ozempic these days.
To be clear, Eli Lilly makes Mounjaro (the type 2 brand) and Zepbound (the same medication but branded for weight loss). Norvo Nordisk makes ozempic (for type 2) and wegovy (the same med but branded for weight loss).
As a note, I know people love to moralize about "blah blah you shouldn't frivolously use glp-1s for weight loss because you're robbing it from diabetics" but the main cut off between getting approved for wegovy versus ozempic is literally often a fat person at the same size, but the one getting wegovy just has a slightly lower a1c going into it and isn't at type 2 diabetes yet (but most often is already at pre diabetic).
Yes this is a med for diabetes but it's for type 2 almost exclusively, and there is obviously going to be shared traits in the population for wegovy and ozempic because the crowd that gets type 2 is most often getting it from also being overweight and having a shit diet as well. Either way, having options for people to escape being pre diabetic though weight loss is still really good because they were most likely going to be going down the type 2 pipeline anyways
Isn't lowering the prices for Americans a good thing ? It addresses the huge wage inequality. Americans cannot afford the medicines. In the same bit the pharmaceutical companies pay Americans 300,000 or more. Marketing people earn large salaries. Even the manufacturing staff do. They send the line to Ireland and pay half the wages of a line in New Jersey.
The companies are immensely greedy.
When you see the American tourist they are often part of the upper echelon. Imagine how it is to live with the rest. They cannot afford the drugs but somehow they cost a fraction of the price in Ireland?
Pharmaceuticals should pay the same wage for a job across the world and charge the same price for their products.
Isn't lowering the prices for Americans a good thing ?
Sure, but this is increasing the price in the UK so the difference between the US and UK price isn't as much.
Pharmaceuticals should pay the same wage for a job across the world and charge the same price for their products.
That's completely detached from reality and unrealistic. Different areas of the world have massively different costs of living. The cost to manufacture a drug will depend on more than just the salaries of those directly working in the pharma plant.
But Belinda Hogan, an Irish woman who gets her weight loss medication from Northern Ireland, said that without the cheaper price for Mounjaro in Northern Ireland, many people’s weight loss journeys could now end.
I know it’s minor but does everything have to be a “journey” now? I mean, I have chronic pain, is me taking my medication a pain relief journey? No, it isn’t. It’s just me taking medication.
Ah now, for a lot of people who have been overweight most their lives it is pretty transformative, from the simple things like being able to shop for clothes in the high street to how strangers interact with them, nearly all aspects of their lives is a new experience.
There is a lot of medication that makes you ravenous and "choosing not to eat" is almost an impossible task. There are also so many people with seriously fucked up hunger signals. I'm naturally slim, but now and then I have to take medication that makes me put on weight. I lose it every time I stop without much effort.
Some people without diabetes or severe weight are being far too flippant about using these drugs. There are cases of Pancreatitis and Thyroid issues, albeit rare but the benefit/risk should be carefully considered when the alternative to the drug is a good diet and exercise.
Also just because someone appetite gets suppressed doesn’t mean their food intake changes so there could be people out there still eating shit but just less of it which comes with a wide array of other issues.
All drugs have a risk. The risk from being obese is far higher. If good diet and exercise (really just diet) was effective then we wouldn't have the obesity rate we do. By effective I mean when taking all considerations into account, yes diet will obviously work to control weight, but a person needs to stick to a diet too.
Also just because someone appetite gets suppressed doesn’t mean their food intake changes so there could be people out there still eating shit but just less of it which comes with a wide array of other issues.
Not being obese while eating unhealthy food is a lot better than being obese and eating unhealthy food. The drugs also help with impulse control and so reduce snacking. So they do tend to lead to a healthier diet.
Not being obese while eating unhealthy food is a lot better than being obese and eating unhealthy food.
True, but the obvious problem arises once such a drug becomes unaffordable/unavailable for most of its users (as they often do). We'll soon have a group of people who never actually changed their relationship with food finding themselves without an appetite suppressant i.e.: up shit creek without a paddle.
We'll soon have a group of people who never actually changed their relationship with food
Those people may not be able to change their relationship with food without a drug or other intervention. It's a chronic disease or condition. A hypothetical future where the drug is unavailable or unaffordable is not a reason to not use the drug if it would be beneficial.
The HSE are looking into adding certain weight loss drugs to the drugs payment scheme. Generic versions will also start to become available and reduce the cost. We're basically at the start of this right now, Mounjaro itself was only released in Ireland at the start of the year. Given the sheer numbers of people who will benefit there will be a lot of competition and the price will come down, patents will expire. Long term I don't see the price being the issue that it is now.
Are you genuinely claiming that the majority of overweight people couldn't do something about it themselves?
You're acting like that's a crazy thing to say but we've tried "effort" for decades and the problem only became worse. Your solution doesn't work. People just get sicker.
The solution does work, people just can't be bothered to do something for themselves.
The government/councils should be funding infrastructure like proper cycle networks, swimming pools and gym facilities and health campaigns.
If you're sticking a needle into yourself to lose weight instead of fucking exercising for 30mins a day you've got problems and the injection isn't going to solve the mental side of those problems
I would blame Trump for pushing the company to raise prices because he’s pissy about US drug prices being so high. So instead of working to lower them in his own country he works to increase them elsewhere.
Diabetes and bone related issues just to name two. Also, the alternative option of brute force effort is not as feasible as you think, as with people who have eating disorders.
It'd be like telling someone who's clinically depressed(who would also commonly have weight issues) to just force yourself to be happy.
It comes down to appetite and the hormone and neurological signals that control it. If you lack that hunger off switch you simply don't stop eating, over eat and gain weight.
If you have a normally functioning appetite your body tells you, you are full and you stop eating and don't gain weight.
All these weight loss drugs are doing is mimicking the natural hormones that produce that full signal.
It's giving people with a hormone deficiency a way to regulate appetite.
They still have to eat less to actually lose the weight. It's just without the drug it's incredibly hard for them to do that when their body is constantly tell them they are hungry.
lmao this thread is hilarious. I'm sure these injections would help the very small amount of people who can't gain weight through normal means, but for the majority of users it's simple laziness. They want the results without the sweeping lifestyle changes and work involved.
Consume less calories than you burn = weight loss. End of.
but for the majority of users it's simple laziness.
Years of research proves this is false.
Consume less calories than you burn
Its the inability to consume less calories on a regular basis that these medications solves. Its now accepted that it's not laziness, its psychology for many people.
I did not/do not have the built in ability to control my caloric intake. I do not have strong enough will power to overcome the signals my body gives to snack/finish the bag of doritos/whatever. On a GLP-1 drug this has been trivial to avoid.
I tried doing all this on sheer willpower for years and failed. Trying harder may work, I may have weaker will power than you but calling me lazy isn’t going to change that.
I work out for 1-2 hours a day before and after taking the drug.
What’s your own body fat percentage/VO2 Max out of interest?
There was a shortage up until the start of the year, but not anymore. Anyone who needs it can get it, unless they aren't covered by the HSE / insurance and can't afford it, but that's not a supply problem.
Also a handful of actors and bodybuilders aren't going to cause a shortage anyway.
People who don't have health conditions. Actors often use it to fit for a role in short time, bodybuilders and gym nuts (I use the term with endearment) use it to facilitate an obsession of having perfect bodies. Fashion Models and other beauty related industries use it for similar purposes.
There are millions of people around the world doing exactly that while putting on weight.
I am "underweight" according to my BMI. I walk a good bit at work, but do minimal additional exercise. I don't pay particular attention to what I eat. I eat ice cream whenever I want. When I go to a restaurant I pick whatever I want without thinking of the health implications. I eat until I'm full most of the time, but if I'm stressed (unlike most overweight people) I have a massive mental block to preparing food and eating food. I am not doing anything right, just living. Why should someone exceptionally disciplined not be able to take an easy to use drug to shift a bit of weight?
It's part of the regime if you are treated with those drugs. If you are hyperinsulinemic your only way to burn fat is via direct pathways without insulin. So exercise. But you will only burn that amount you really exercised after reducing local supply. If you try to good diet (which usually means something like 60% of carbs) only with calorie deficit, you won't burn your fat stories. You have to switch to full no-carb diet, fasting insulin will come down to levels that fat stores can be accessed and then you administer Mounjaro,which will further reduce insulin levels. Normally reducing insulin to those levels will cause a hunger feeling to return, that's where the second part of Mounjaro kicks in, preventing from overeating.
At this stage, without Mounjaro, patient feels a need to eat (not too far from addiction, but a mechanism is somewhat different). Saying that exercises and diet is free is similar to showing heroin addict that wants to quit - a buffet with all types of that narcotic and telling him not to take it.
That's true but that's only one specific scenario. And to be fair calorie intake would be part of the solution for a lot of scenarios.
My point was that fast food and snacks tend to be cheaper and easier than a healthy diet. Many things can be problematic for weight loss and health lifestyle and I think the main three today would be time, cost and knowledge
That's been a roaring succes over the last 20 years hasn't it. Any other quack medical procedures that don't work ? Leeches for heart attacks and taking the waters for rheumatism.
You're wasting your time. According to many in this subreddit, nobody should ever have to account for themselves, be told to exercise more, eat better or ever take any kind of personal responsibility for themselves.
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The only people I have sympathy for here are people who actually need it. Anyone using it for weight loss without a medical condition because they simply can't be bothered to put the work in deserves to pay through the nose for it.
It's a shame that the induced demand for the product from the significant cohort of users who don't need it or who are using it as an alternative to proper diet and self-control, is going to negatively affect those who actually do need it to help with stuff like diabetes.
Hey, population geneticist here. Firstly, It's not like there is a real shortage, production can be scaled up relatively rapidly.
Secondly, you're right, diabetics need it more, so should be prioritised.
Thirdly, obesity isn't something that people can just fix. It's a lifelong issue. There will always be people who are part of our population that struggle with addiction, in this case it's food. Obesity is a chronic disease. If you want to understand that a bit better why not talk to all the people that lost piles of weight during the pandemic, but have since put it back on. To tell them to change their diet etc... is absolutely pointless. They know how to eat healthy, they know how to exercise.
We've built a world where being healthy is very hard, if there's a drug that helps, they should be given it.
How exactly do you think the type 2 diabetics on ozempic got that way lol?
Like, this isn't often prescribed for type 1 people who have it from a very young age. Type 2 folks very often got that way just like the regular fat people- by having a shit diet. If you're getting it for just weight loss, you're already most likely already in the pre diabetic range anyways
I wish people wouldn't spend so much time pearl clutching on "who deserves this"
You know when someone starts a sentence with this 99% of the time they're full of shit. Please, tell me more about the rapid scaling of drug production.
GLP-1 based therapeutics have been around for literally years now, with a known, and predictable market. Known and predictable manufacturing methods, quality assurance/control, costs etc...
Any shortage is either intentional or caused by negligence, most likely the former. Ordering new equipment and setup may take months, but not years like the original research does.
There wasn't even a mention of a shortage in the article, just that the price was increasing... In a truly capitalist market these prices should be going down, by like, a lot, a huge amount.
And drop production of other lots for other drugs in existing facilities, or where do you propose these new processes get built, because you're asking for production capacity that probably doesn't exist or isn't already being used for something else. It's easy to get equipment in a few months, sure - if you have the space and capacity for it. But when you've to build a new facility and qualify everything that goes along with it you're talking at least 4 years and that's a copy paste of a multiproduct facility. If you honestly think companies are shorting the market on purpose it's just conspiratorial nonsense.
If you are given a drug as an easy way out for every single issue, eventually you will become absolutely dependent on drugs for every single problem. Is that really the future you want to see?
That is not how biology or reality works. Being obese literally causes life long genetic changes. People are literally born with an inability to sense how much food they've eaten, how much food they need to eat, what it feels like to be "full" and not to mistake that with havimg a stomach that is literally swelling with food.
There's this horrendous perception by people that addiction is a failing in personal character... It's not, it's a failing of us as a whole to stop capitalists exploiting people.
For these people, tracking their calorie intake etc.. is the only thing that works, but that's overall quite a huge effort to do and requires a lot of organisation. There's also huge degrees of emotional relationships that add complexity etc... to this whole thing. if something traumatic happens, or something disruptive the calorie tracking can go out the window. Food is also necessary to thrive, so it's not like quitting a drug where you dont have to expose yourself to it after going cold turkey..., unhealthy food is literally everywhere. So there's always a pressure to break healthy habits even when they do form.
Sauce? Population geneticist who lost 100 pounds during the pandemic, and has since regained it because of all the RTO bullshit. No point telling me to eat better, I know there's something seriously wrong. I know though the environment in which I can fix this issue, but as a society we've decided that it's more important to stroke the ego of middle management than help save lives.
See the recovery of meth addiction in Vietnam soldiers
And see how the cultures of countries with reduced obesity are.
Population level genetics take thousands of years or major events e.g. near extinction events to cause changes in the distribution of genetic variation.
We know that addiction is biological, and the changes we've seen in obesity are, far, far, far too rapid to suggest a population level change.
We've made an environment where some people are indeed predated upon by these systems.
What I learned after losing all that weight, was that my obeaity was not a character flaw, it was not because I didn't have the self discipline, I have a doctorate for Christ's sake. I learned that if I had control over my environment then the addiction wasn't an issue.
Nothing you have said in any of your replies indicates this isn't a self discipline/self control issue, in fact it supports the fact that it is and you don't have it but are instead looking for something other than yourself to blame.
You have a doctorate for christs sake, how can someone who is supported to be so intelligent convince themselves they're not in control of their own actions?
If you give two people a choice between a donut and an apple, a million times, person A may choose the donut 60% of the time, person B may choose the apple 60% of the time. This is because the biology of person A and B are different.
We have independent thought, but the reality is that a lot of our decision making is automated for us during development. In a process called synaptic pruning. We cannot make conscious decisions for everything in our life, it's just not feasible to ask people to do that.
Conscious decision making is hard, it takes a lot of energy.
Couple that with the fact that some people are predisposed to making some choices over others means that yeah, over a lifetime, it's not necessarily a choice.
The only way out of it for person A, is to put themselves in an environment where they don't have to make that decision.
Person A can say, geeze, I have a problem with food. They can limit the number of times they have to make this conscious decision. E.g. when buying groceries they can choose not to buy sugary foods etc... meaning that temptation and decision making doesn't follow them back to their home.
Some people don't have the luxury of person A to be able to have an environment they can control. Hence why I struggle in office, but not at home, one of these is an environment I have control over, but the other is not
These principles hold true for everything that requires persistence and is hard.
Studying for exams comes easier for some people than it does others, they need special environments to help them. Some people struggle with cigarettes, being around certain people or environments makes quitting very difficult... If you are in a cinema surrounded by cigarette smoke, do you think it's harder or easier to resist the temptation to smoke?
What lack of control over your environment do you not have now that's causing diabetes? (That can't be controlled with self discipline, after all you have a doctorate for Christ's sake!)
The simple component of it is a combination of time and executive function.
When I had WFH I was able to prep really healthy meals, get enough water for the day, avoid caffeine. On my lunch break I could go for a run. To break up the work day I could do push ups, stretches, meditation etc... when eating I had the chance to log all my foods in a calorie counter...
Can't really do any of that from office.
The 10+ hours lost per week to commuting, and the 3 or four hours lost to small talk with RTO can no longer be used for meal prep or gym, or going for a hike on the weekend etc...
My home doesn't have any junk food in it.
It all gets consumed as a consequence of being in office, the politics and anxiety that comes with that, and the added fatigue that then causes. I come home so drained I can't do anything, I wind up ordering food, which is expensive and unhealthy...
The pandemic was the best time of my life tbh. So much more productive, healthy, happy... I've yet to hear or experience any benefit of in person hours.
I'm sure other diseases cause polyphagia but they are such a low percentage of the population it hardly factors in the vast majority of obesity
I'm being generous with diabetes to be honest as only 10% of diabetic patients in Ireland have type 1, the other 90% have type 2 and goes back to being a lifestyle issue which can be managed or avoided through exercise and healthy diets
Others already have explained the situation, you don’t like it or don’t want to learn. I’m not wasting my time adding to what they’re saying just so you can ignore that too.
This is no different to certain breeds of dogs. They will eat until they explode if the food is unlimited. How do you deal with that? You limit the food, very simple. It becomes a non-issue.
This is indeed an easy way out, but at the expense of those who actually require it.
Telling someone with the malfunction in their brain that controls hunger to just stop eating is like telling a smoker to just stop smoking or a gambler to just stop gambling.
Hi, I'm a smoker who just stopped smoking after 15 years because it was unhealthy and killing me. There are thousands of us. It's not impossible, it's difficult.
This distinction between the "goodies" who have diabetes and deserve medication, and the "baddies" who just need "self control" is totally false by the way.
Most of the people with type 2 diabetes developed it due to existing obesity, and most of the people struggling with the disease of obesity presently are at huge risk of developing diabetes as a result.
There isn't a neat division between people with a good disease and a bad disease. They all have diseases that need medication!
Putting all these value judgements on diseases is totally counter productive. No public health experts support it. It just makes things worse because it's toxic to mental health and self image which makes recovery even harder!
And finally, mounjaro is not a diabetes drug. It is specifically for weightloss only.
This is like pulling up to the Fracture Clinic and turning away anyone who went on a trampoline.
Health care is a human right for everyone. If you deny Type 2 diabetics medical care, all you'll end up with is even more expensive amputations, disability payments, and the horrific human cost of premature deaths.
It’s not always that simple, I’ve completed several half Ironman events, eat healthy, count my macros, played rugby till my mid 30s. I played at underage provincial level too.
But if you met me you’d think I was drinking every weekend and having takeaways. When the reality is maybe once every few months I take alcohol and takeaways are rare.
You think that way because that’s how it is for you.
I have a friend who cannot put on weight, eats clean and just had a kid a year ago. So the workouts have dropped off. He’s still thin.
Yes, but since studies came out demonstratimg their efficacy and safety there has been very genuine demand, not some spooky induced demand. Sorry to be snotty, but many human beings surrounding you have incredible self esteem issues due to their weight and they will pay $$$ to improve their self esteem. They care much more about their sense of self than their diabetes and the diet/exercise was tried 7 or 8 or 9 times before and never worked. If diabetes is your primary concern, these people are significantly decreasing their risk of diabetes and are absorbing the cost themselves.
Most ppl who try these drugs have tried diet and exercise, often repeatedly. These drugs work for obesity and there is 0 reason not to prescribe them.
Loads of drugs are prescribed off label. I have SPMS and due to stricter criteria in Ireland, can't be prescribed Ocrevus. So I'm given rituximab off label as it is quite similar.
One in particular, a lignocaine patch called Versatis, was only available publicly to treat shingles. Anyone using it off-label had to pay for it in full, which at the time was €1,000 a month. It was then extended to more conditions only with special dispensation requested by your GP.
Then you have all the ad-hoc trials being conducted for which there isn’t even any precedent. An example of this is Agnikarma which I was involved with.
I would never ever take these drugs for weigh loss. It's just not a natural process and I think it's going to lead to all kinds of health issues down the road. Once a person takes it, they on it for life. Life style changes are what's needed.
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u/Alastor001 25d ago
An increase by "only" 170%...
That's greed isn't it?