Ozempic and Wegovy are selected for Medicare's price negotiations

Crazy right? Here in europe they just tell me that my medication isn't covered and I have to pay the whole price for it - if I don't like it, I can switch the government and move somewhere else.

Does your country cover ozempic for obesity? In Canada we don't for non diabetics.

Americans get more drugs covered on average is my impression.

IT IS a worn out stereotype. I'm also European and here the doctors are also limited by the national health insurance company on what medication and treatments they can prescribe you due to cost reduction pressure. Their hands are also tied except not by a private corporation but by the government.

Often you'll encounter the infamous "these tests or procedures aren't covered by the national insurance anymore so you'll have to pay out of pocket", or they're covered, but the nearest appointment on the national insurance is 15 months away, at which point you'll either get better or you'll be dead.

My boss recently moved from Germany to the US and was pleasantly surprised how much better the diagnostic, treatment and medication options are for his child who suffers from some rare mental disorder that's basically ignored in Germany by comparison. US seems to always be on the cutting edge of medical research and treatment which of course comes at a cost since research is very expressive.

Ozempic in Europe seems to be cheap, under $100 in many cases. In the US it costs 10x or more that. So as much as I hate to defend insurance companies, it's not just them.

I get this sounds crazy.

But what’s more crazy is the prospect your doctor is motivated by profit.

Does that mean it’s less likely to be true?

I’ve had some interactions with doctors that would chill your soul.

“Here’s some long acting opiates. Take three a day for a month.”

I’ve had doctors offer me antibiotics for the flu.

I’ve been offered surgeries for conditions that don’t require them.

I’ve seen doctors offer a week in the psych hospital over mild distress.

You think that is jarring? How about a drug company giving kickbacks to doctors to tell patients they need a drug?

Four companies. The doctor's office which may be controlled by profit-optimizing administration, the big profit pharma corporation, the for-profit medical insurance company, and the company the insured works for who picks the available insurance plan(s).

Don't forget getting an e-mail about it from HR??

No. HIPAA is rarely straightforward, and in any event it’s not uncommon for employers to have some degree of access to claims data. In a case like this I assume the company self-funds the plan.

I'm 99% sure HIPAA just applies to medical personnel (i.e. nurses, doctors) so they can't outright share private information. Third parties (i.e. your mom or insurance companies) can share it all day without violating HIPAA.

It does not protect your medical data whatsoever.

You were obviously not able to understand my argument.

Ozempic treats a problems (overweight) and might prevent problems further down the road (diabetes, high blood pressure, heart problems etc.) with trade offs like higher risk for specific cancers.

It does not treat the underlying cause ob obesity. One that might be highly processed food and Kennedy, whatever you think of him, stated this correctly.

Where in my post do you see that I said that Ozempic should not be made available? Please work on your reading abilities.

I started keto in June of 24, lost 50lbs and added a compounded version of Ozempic in November to get through the holiday season with a little extra help. I'm on a fairly low dose, 50mg/week, and it's working tremendously. I've lost another 25lbs up to now and it's about 10x times easier to stick with keto, macro logging, and calorie tracking.

I feel like even with keeping my calories to about 1500/day I'm just fine, and the cravings for sweets and over indulging just aren't in my head.

There are different keto diets.

The epilepsy version is indeed hard to maintain, but can be life changing (increase life quality in epilepsy, bipolar, schizophrenia etc)

The T2D version is way easier. If you studdy it or get a coach, you will know all the pitfalls. But its like therapy, you need to want it yourself. Cant be forced into it.

We aren't other state insurance systems, though.

Instead, we have a divided and fractured jigsaw and heavy lobbying to keep it that way.

Although you're right, it's a little misleading.

The point is that governments won't pay any price, they usually negotiate a (good) price given their buying power. As you say they may not buy it, but countries that dictate a price (generally) cannot force a company to supply it.

Ultimately it comes down to market forces, even if the market looks very strange, with essentially one buyer and one seller.

Nonsetrile compounding, like you'd do from the peptide sites is only safe for immediate use, and semaglutide is not that way. You mix up a vial and use it for a month or so.

Can you do it? Sure. Are you going to get an infection from it? Probably not. Is it riskier than having a compounding pharmacy doing it the right way? Absolutely, and in a meaningful amount of risk. The type of infections you get from contaminated injections are not something you want to deal with

Except you have to figure out who is actually selling legit stuff at the real dosage.

From a quick look earlier this week that's not easy, and I've dealt with research peptide sites before. I was hoping to try one of the ones that's newer than Semaglutide for my IBS - that worked really well the later half of the week but not the first few days where it made things worse. I don't need to lose weight but I'd love to get that under control better.

Check out local weight-loss and hormone clinics, which often have connections to reliable compounding pharmacies.

Drugs cost what they cost because of R&D, not manufacturing.

Look at how cheap generics are, that's what it costs to actually make and distribute a drug.

The pharma business model is that you spend incredible amounts of money on doing research, identifying promising drugs, doing trials, and overcoming all the regulatory hurdles you need to overcome to get the drugs to market. You then get a 20-year[1] exclusivity deal on your newly-introduced drug through patents, which you use to recoup your costs.

You don't just recoup the costs of inventing this particular drug, but also all the other drugs that seemed promising, had all that money spend on trials, but ended up just a bit too ineffective to ever be sold.

We could abolish the patent system and genericize everything, and that would instantly bring drug prices down massively, but then we wouldn't ever see any new drugs being researched.

It feels very conspiratorial to suggest multinational pharmaceutical companies are creating low quality versions of their own branded drugs in Europe.

We know that these drugs cost roughly $10/dose to produce, and most of that is the auto-injector pens. Hardly seems worth ruining their reputation and getting punished be regulators to save a few dollars on something with a 600-6000% markup.

They could benchmark the price against comparable countries/regions. Pay no more than, say, 110% of the average cost of the drug in Europe.

They can do what India and some other countries do, and legislatively ignore pharmaceutical patents when it comes to public health if drug is deemed unaffordable.

It's not on the table in the first place. Trump is just forcing fake news MSM to talk about BS to disorient them and make it harder to attack his transition. Expect more of this - he seems to be advised by someone competent this time.

What, specifically, wasn’t HHS allowed to do? They weren’t purchasing the drugs.

Certainly the VA can and does negotiate prices for the drugs it buys (that’s one input to the HHS Medicare price-fixing formula), but it has a formulary and is buying drugs for its patients directly.

> The better solution is to allow parallel trade of pharmaceutical across borders.

No, no it's only a global economy when companies want to manufacture products using slaves in third world countries or they want to outsource programmers and call center employees, but not when consumers want to buy medications or DVDs at the prices they sell for in those same countries or even just want to get higher quality products they refuse to sell you here (https://www.cbsnews.com/news/hershey-sues-shops-importing-br...)

Or simply set our prices to the average or median of something like 5 hand-picked other countries - and make that not only for Medicare/caid but also for everyone else. It's ridiculous that hasn't been done yet.

We can debate the merits of various drug pricing schemes but at the end of the day, prices are set by a small group of interested actors who want the prices to be as high as they possibly can without causing a violet revolt. So call it what you will but let's not pretend there's some deeper, more important meaning to be sussed out here.

Yeah. I've seen some split between low vs high doses, where the first two doses cost less than the rest - a cynical take is that they want to make it cheaper to get started knowing they will get you hooked possibly for life, or at least the duration of their patent.

But yes, non-linear by design - a 15mg dose provides 6x the medication but cannot be sold for 6x the price or people will stay on lower doses (or discontinue) rather than going to a higher dose.

Meanwhile it provides 6x the medication. One multi-use 4-week pen has enough to provide 12 weeks of doses at 4-week titration if used off-label. Obviously this is only helpful on low doses.

Important note: I am not a doctor, I don't recommend doing this - in fact, I have not done it myself and will probably not do it in future. I have seen YouTube videos of medical professionals explaining how to dose split weight loss drugs though.

I would highly recommend dose splitting the brand name drug over picking some compounding pharmacy's version of the drug, or worse, buying it off the street. It's crazy though, there are even counterfeit medications in the supply chain sometimes, for example: https://www.fda.gov/drugs/drug-safety-and-availability/fda-w...

Worth to whom? Greenland has about 44,000 inhabitants over age 17. I would imagine a majority would be willing to sell their citizenship to the US for quite a bit less than a million dollars each....

> it's nothing compared to the many trillions of dollars Greenland is worth.

All of these trillions are imaginary numbers buried in ice

> they're concerned because a violent, hegemonic imperialist superpower

To be fair we learned it from watching Dad (England).

> unstable authoritarian regime

How is it unstable?

> apparently just because

Territorial waters and exclusive economic zone claims grant amazing access to the arctic.

> something the US wants

It's really just the moneyed interests inside of it. China and Russia seem to have the same bent for the same reasons. It was recently unusual in Iraq since the federal corruption had risen to such a level, enabled by 9/11, that lackies for these interests somehow found themselves directly employed by government.

I prefer nuance over hyperbole.

That seems unlikely. Peace in Europe exists because the United States threatens its absence with a fist by its heart. America had to save Europe from destroying itself once and now the US has pacified Europe by placing its troops and weapons there lest the nations turn on each other in uncivilized violence again. And then again, when they dragged their feet, the US had to blow up their gas pipelines pour encourager les autres. The continent is incapable of protecting its own shipping lanes without US support and NATO acts as a deterrent solely because the US is in it. Take it out and the Europeans will spend the majority of their time telling everyone how it's not a big deal that Ukraine will fall to Russia, and Poland, and so on.