Across the country, some overweight consumers are paying $10,000 a year or more to get popular drugs from Eli Lilly and Co. and Novo Nordisk. Patients report taking on second jobs, racking up credit cards and cutting back on travel or family expenses to afford Lilly’s Mounjaro, a diabetes drug being used off-label for weight loss. They are also self paying for off-label use of Novo’s diabetes drug, Ozempic, and sister drug Wegovy, which is approved for weight loss.
The willingness of consumers to pay thousands of dollars of their own money underscores the public’s appetite for more effective weight-loss medications, especially for people who have long struggled with obesity. The injectable medications can result in patients losing roughly more than 15% of their body weight.
Consumers are paying significant sums out of pocket in large part because insurers are denying coverage for weight loss. In addition, the drugmakers are charging the full list price of a drug instead of offering any of the discounts they give to health plans.
Insurers may deny coverage of weight-loss drugs or drugs that are used off-label for weight loss.
Lilly and Novo didn’t comment on why they charge people list prices for their products when coverage is denied.
Many commercial health plans and federal programs such as Medicare won’t cover the drugs in part because they are viewed as lifestyle medications rather than lifesaving medications that treat the chronic disease of obesity.
Only 43% of health-plan sponsors cover FDA-approved weight-loss drugs, according to a June report by Pharmaceutical Strategies Group, a pharmacy intelligence and technology company.
Some are turning to mexico where you can purchase Ozempic for as low as $285. One woman went down to Mexico to get Ozempic after it was prescribed to her, saying she was able to purchase it at a Costco in Cabo San Lucas. “I didn’t have any problems going through customs or security or TSA,” said Gina Kingswood on her YouTube channel
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