The Costs of the New Weight Loss Hope Could Be Very High.

• Author: Cotti, Chad

There has been a great deal of interest in a relatively new class of diabetes drugs known as GLP-1 agonists. Better known by such brand names as Ozempic, Rybelsus, and Mounjaro, these medications help treat type 2 diabetes by stimulating insulin production after eating, which lowers blood sugar levels. What makes them of special interest, though, is that they also promote a feeling of fullness and act to reduce appetite, which promotes weight loss. The results of GLP-1s as weight-loss drugs have been remarkable, with the Mayo Clinic noting studies showing that people on a weight loss program who used one of these drugs, semaglutide, lost about 33.7 pounds versus 5.7 pounds for those who didn't use the drug.

This has led to the hope that GLP-1 medications could be used broadly to treat the obesity epidemic afflicting the United States. In fact, it appears that many people began taking these drugs to lose weight even before the Food and Drug Administration gave formal approval for that purpose, to the extent that drug shortages have been reported.

There is little doubt that the demand for a drug that could help a person lose weight would be high. The obesity crisis in the United States has been spiraling for decades, and it has caused or contributed to a variety of afflictions as well as early deaths for millions of Americans while costing the health system hundreds of billions of dollars each year. More than 40 percent of U.S. adults are considered clinically obese.

Costs and concerns/ Given the effects that obesity has on our society, it is understandable that so many have put their hope into these drugs as a solution for drastically improving health outcomes. For instance, there are now calls for health insurance to cover these drugs when used as a weight loss treatment, and there is bipartisan legislation--the Treat and Reduce Obesity Act--that would authorize Medicare Part D to cover GLP-1 medications.

However, authorizing the coverage of GLP-1 drugs for weight loss would be extremely expensive. A recent study in the New England Journal of Medicine estimated that the annual cost to Medicare could be $13 billion to $26 billion a year, which at the high end would increase the total annual cost of Medicare Part D spending by approximately 25 percent. The cost to private health insurers would be even greater: one estimate is that total annual U.S. spending, private and public, on this class of drugs could exceed $100 billion by the next...