Astral Codex Ten Podcast

The Ozempocalypse Is Nigh

Mar 21, 2025

The podcast dives into the world of GLP-1 weight loss drugs, discussing their high costs and how a recent FDA ruling has ended a drug shortage. With prices skyrocketing, telehealth startups have offered affordable alternatives by sourcing medications in unconventional ways. It examines the potential fallout for millions who rely on these drugs as the market shifts. The conversation also touches on the risks of self-administered medications and the mixed bag of innovation and safety in the evolving pharmaceutical landscape.

10:06

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Quick takeaways

The recent end of the drug shortage for GLP-1 medications threatens affordable access for over 2 million Americans who need them long-term.

Pharmaceutical companies are adapting by creating direct-to-consumer models, aiming to balance accessibility of medications while preventing price exploitation.

Deep dives

Impact of Drug Shortages on Accessibility

Three primary GLP-1 drugs for weight loss have been available in the U.S., but their steep monthly costs place them beyond the reach of many Americans. For the past three years, a drug shortage allowed compounding pharmacies to legally sell these medications at lower prices, making them accessible to over 2 million individuals. However, with the FDA declaring the shortage over, these affordable options will no longer be available, leaving many patients at risk of reverting to their previous weight. This situation raises concerns about the sustainability of treatment for those who have become reliant on these drugs for long-term weight management.

Navigating the GLP-1 Drug Market: Costs, Shortages, and Industry Strategies

8min

Exploring the Risks and Innovations in Self-Administered Medicine

2min

Sorry, you can only get drugs when there's a drug shortage.

Three GLP-1 drugs are approved for weight loss in the United States:

Semaglutide (Ozempic®, Wegovy®, Rybelsus®)
Tirzepatide (Mounjaro®, Zepbound®)
Liraglutide (Victoza®, Saxenda®)

…but liraglutide is noticeably worse than the others, and most people prefer either semaglutide or tirzepatide. These cost about $1000/month and are rarely covered by insurance, putting them out of reach for most Americans.

…if you buy them from the pharma companies, like a chump. For the past three years, there’s been a shortage of these drugs. FDA regulations say that during a shortage, it’s semi-legal for compounding pharmacies to provide medications without getting the patent-holders’ permission. In practice, that means they get cheap peptides from China, do some minimal safety testing in house, and sell them online.

So for the past three years, telehealth startups working with compounding pharmacies have sold these drugs for about $200/month. Over two million Americans have made use of this loophole to get weight loss drugs for cheap. But there was always a looming question - what happens when the shortage ends? Many people have to stay on GLP-1 drugs permanently, or else they risk regaining their lost weight. But many can’t afford $1000/month. What happens to them?

Now we’ll find out. At the end of last year, the FDA declared the shortage over. The compounding pharmacies appealed the decision, but last month the FDA confirmed its decision was final. As of March 19 (for tirzepatide) and April 22 (for semaglutide), compounding pharmacies will no longer be able to sell cheap GLP-1 drugs.

Let’s take a second to think of the real victims here: telehealth company stockholders.

https://www.astralcodexten.com/p/the-ozempocalypse-is-nigh

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Astral Codex Ten Podcast

The Ozempocalypse Is Nigh

Podcast summary created with Snipd AI

Quick takeaways

Deep dives

Impact of Drug Shortages on Accessibility

Emerging Strategies in the Pharmaceutical Landscape

Remember Everything You Learn from Podcasts