K.She thought she had finally succeeded.
After years of dieting, exercising regularly, failing obesity treatments and being ashamed of being overweight, a 49-year-old teacher from Missouri took a pill to help her lose 25 pounds in three months. I found. “It was life-changing for her,” she says.
Not only did Kay lose weight, she experienced an almost miraculous change. She soon noticed that the painful cramps from her fibroids were gone and the swelling in her legs was gone.”She can go for walks again,” Kay told me. rice field. She even stopped taking Wellbutrin. “It became more than just weight loss.”
Then it was all taken away. New diabetes drug Munjaro was behind Kay’s weight loss, but her change became out of reach and unsustainable when manufacturer Eli Lilly changed the terms of her coupon. If she wants to keep losing weight, living pain-free, and avoiding the dreaded diabetes diagnosis, she’ll have to pay $1,000 a month. She was paying with Eli Lilly’s original savings program. Munjaro, a well-known brand of tirzepatide, is one of her in a new class of nutrient-stimulating hormone-based therapies that have changed the way type 2 diabetes (T2D) is treated. While similar treatments target her hormone called GLP-1, Lilly’s Mounjaro is the first treatment to target a second hormone, her GIP. Together, these hormones reduce appetite, slow gastric emptying, and make you feel fuller for longer. A 2022 study on tirzepatide found that participants lost an average of 22.5% of their weight. In another study, Novohi Nordisk celebrity endorsed Ozempic, which targets only GLP-1, showed an average weight loss of 16.9%.
This significant side effect of Munjaro — rapid weight loss comparable to bariatric surgery — has been shown to be beneficial for diabetics, obese patients who want to avoid a diagnosis of type 2 diabetes, and people seeking to improve their physical and mental health through weight loss. in between, making this drug a violent flash point. Insurance company, Eli Lilly.
The lack of two of Mounjaro and its GLP-1 predecessors, Ozempic and Trulicity, has led to a growing conflict, which has flared up on social media. Diabetics think obese people are stealing their medicine. This is because it is currently only approved for the treatment of type 2 diabetes ( FDA approved A cure for obesity could appear as early as this summer. ) Obese people are upset that obesity is not recognized as a disease. And users who can’t afford it say they’ve been abandoned by big pharmaceutical companies.
“For the first time in a long time, I felt like a normal person,” says Jordan Goodwin, 30, a Dallas native with polycystic ovary syndrome (PCOS). stopped working unexpectedly and I couldn’t get my medicine.”Now it’s all back and I’m never bored.I’m going to allow myself to be diabetic so I can get medicine that works.” should?”
This is why Lilly’s decision to change the coupon terms hit her patients hard. “Patients probably didn’t realize there was a time limit in the first place, but they were moving the ball, so to speak,” said Michelle Melo, a professor of law and health policy at Stanford University. I moved it up to create a dependency and then pulled the rug out even faster.”
Even if Munjaro is approved for treating obesity, it would cost about $13,000 a year. “Surprisingly, it’s no more cost-effective than Ozempic,” said Dr. David Rind, chief medical officer of the Institute for Clinical and Economic Review.
Kay and Jordan are slowly gaining weight back, but they reluctantly participate in a “yo-yo diet,” a lifelong cycle of weight loss and gain. Studies show that weight cycling stresses the cardiovascular system and affects psychological health. Weight cyclers are at risk of adverse effects such as blood pressure, heart rate variability, and erratic levels of glucose, lipids, and insulin.
Even diabetics, who are Munjaro’s only approved beneficiaries so far, find the drug out of reach due to inadequate supplies, denial of insurance, and out-of-pocket costs.
Holly Lofton, Ph.D., director of weight management programs at NYU Langone Health, said: “They’re losing out because they have poor glucose control and increased fat cell size, which means they have increased inflammation.” , which could put them at a disadvantage.”
What was a miracle drug for many is now almost impossible to obtain.
“Is it really the right thing to do if they get people to start doing something that’s dangerous to stop?” Seton Hall Center for Health and Pharmaceutical Law and Policy asked Professor Karl Coleman of “Is it appropriate to encourage someone who would not be able to take it without a plan? [without] Allow them to keep taking it?
When Eli Lilly munjaro debut In May 2022, anyone with corporate insurance will be issued a coupon to use Mounjaro for as low as $25 per month until July 2023, even if they are not covered by their corporate insurance company. Did. Massive demand has caught up with supply, driven by social media success stories, low costs, and telemedicine companies willing to prescribe Munjaro off-label more aggressively than traditional primary care physicians. In November, out of the blue, Eli Lilly Clause The result was massive turmoil and bitter encounters both online and in pharmacies nationwide.
Sarah, a pharmacist at Walmart, Alabama, said, “The manufacturer has not announced any changes to their terms and conditions.” I had to poke through online forums.”
What Sara discovered was that Eli Lilly’s “new” coupon required patients to prove:
T2D diagnosis. The new discounted price he has increased from $25 to $500, but only for those with insurance that covers Munjaro. Otherwise, the miracle drug costs about $1,000 a month.
A spokesperson for Eli Lilly said, “Lilly’s Tirzepatide Savings Program is designed for adults with commercial insurance in the United States who have been diagnosed with type 2 diabetes and have been prescribed tirzepatide within the scope of their marketing authorization (“on-label”). Intended for patients only. “We have added a patient certificate highlighting his type 2 diabetes requirements to the Savings Program page, and by November 2022 and he amending the program’s terms and conditions from January 2023, we will extend this use. strengthened.”
Customers spike when coupons suddenly stop working, begging Sara to find a way to keep the old coupon prices. She absorbed the patient’s frustration with Lily and her insurance company. They asked again and again.
“Patients felt we had fabricated everything they were missing,” says Matt, an Indianapolis pharmacist who works for a major retail pharmacy chain. “One woman said, ‘You’re refusing my medication. You don’t want me to have it. And she threatened to sue us.'”
In the gladiator pits on Reddit and Facebook, obese and diabetic people are fighting over who has rights to Munjaro.
Lauren Rogers, a diabetic from Wheeling, West Virginia, said, “I don’t like the anger that many in the weight loss community are showing towards people with diabetes.” ‘doesn’t help control blood sugar’ or ‘take another diabetes medicine’.It really hurts.”
Diabetics accuse obese patients of causing Munjaro’s supply problems, but those suffering from obesity want to be perceived as a disease rather than a moral failure. Citing munjaro as a preventive drug, he is outraged to hear that such a drug is not worthy. doing.
“Obesity is a no-brainer. It’s a complex, chronic neurometabolic disease with distinct pathophysiology,” said an endocrinologist and obesity medicine physician-scientist at Yale University. paper Shows excellent efficacy of tirzepatide for obesity.
When someone takes an anti-obesity drug like Munjaro, it readjusts the amount of fat the body wants to keep, and usually loses weight. comes back,” says Jastreboff. “You have to keep taking your medication to maintain your newly readjusted protected fat mass and continue to lose weight.”
An Eli Lilly spokesperson said, “We are committed to ensuring that people with type 2 diabetes can continue to use their prescription drugs as normal.” I’m still working on getting my medication.”
Due to the deficiency, Rogers had to stop taking Munjaro for three weeks. “I was devastated by it and full of despair,” said the 58-year-old woman. She said, “She gained a few pounds back and I was surprised at how bad she looked when she lost it. [blood glucose] The numbers got out of control again. It was a wake-up call to understand how diabetes can make you sick. ”
Amid all the grievances, Munjaro looks like a goldmine. Bank of America analyst Jeff Meacham said, “We’re modeled for 2024, and we’ve hit $4.7 billion in sales worldwide. UBS analyst Colin Bristow said Mounjaro. “Mounjaro’s current estimated sales will be about $30 billion by the end of 2010,” he said.
“Munjaro is a game changer, it’s not an exaggeration,” said Paul Ford, a 53-year-old former firefighter who said he lost 30 pounds and no longer needed to use a CPAP machine to sleep. “I feel so much better.
Munjaro could very well become one of the most profitable medicines ever, and could radically improve the lives of tens of millions of people. But for many of the drug’s early adopters, Munjaro’s promise set them up for another round of weight gain, comorbidities, and despair.
“It’s almost a bad thing to know it’s there, but it’s out of reach,” said Kay. We could have come up with some solutions.” For now, she lives in anxiety and there is no guarantee she will ever have access to medication again.
