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.
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GLP-1 Drugs for Weight Loss
Three GLP-1 drugs (semaglutide, tirzepatide, liraglutide) are approved for weight loss in the US.
Liraglutide is less effective, while semaglutide and tirzepatide are preferred but costly at $1,000/month.
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Compounding Pharmacy Loophole
A drug shortage allowed compounding pharmacies to sell cheaper GLP-1 drugs.
They obtained peptides from China, conducted minimal testing, and sold them online for about $200/month.
question_answer ANECDOTE
HIMS Stock Fluctuation
HIMS stock rose when the FDA declared the drug shortage over, then dropped significantly.
The stock's fluctuation reflects the market's reaction to the FDA's decision.
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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.