Wegovy, Ozempic etc.

[Dorian]

As of the new year, my insurance no longer covers Wegovy. Imagine my surprise to see it cost over 700 dollars for one month.
I guess I don't totally get it. It has covered surgeries costing over a hundred thousand and covering weight loss seems to me to be a good return on investment, since an overweight person is probably going to cost more than they pay.
Does anyone else take this?

 

[OccamsRazor]

Prescription roulette is not uncommon. Drugs being re-classified and changed frequently is not uncommon. My elderly mother takes many script drugs. Seems they change month to month. Just this last month she was taking a med that was costing her ~$120 per refill. Earlier this week, she went to get a refill and it was now ~$400.

 

[vraiblonde]

They have to pay for all that advertising somehow....

I'm not a fan of Big Pharma because they come across as nothing more than drug pushers, no different from the guy on the corner. And once they get you hooked on a "taste" they can charge whatever they want and they know you'll pay it.

 

[OccamsRazor]

They have to pay for all that advertising somehow....

I'm not a fan of Big Pharma because they come across as nothing more than drug pushers, no different from the guy on the corner. And once they get you hooked on a "taste" they can charge whatever they want and they know you'll pay it.

More like "they know you need it to survive" so you will pay whatever the cost which is 10x more despicable!

 

[vraiblonde]

More like "they know you need it to survive" so you will pay whatever the cost which is 10x more despicable!

Agree on some level, but many times people are convinced they need a drug to survive when in fact they don't. Anecdote time:

One of my clients was on an endless cocktail of medication for various whathaveyou. He took this drug for blood pressure or whatever it was, then took another drug to lessen the side effects of the first drug, then another drug to boost the first drug because the second drug lowered the efficacy, and on and on it went. He was wiped out and had lost his will to live, not to mention spending a fortune.

One day I went in to see him and he looked better than he had in years. I said, wow, they must have finally figured your meds out, and he said, "Nope. I stopped taking them." He decided he'd rather die than live in a constant state of depression and lethargy, so he quit them all cold turkey and in about 2 weeks he started feeling better. In a month or so he was in the pink. He still apparently had the high blood pressure or cholesterol or whatever it was, but it turned out not the be the killer the doctors said it was and he lived to be in his 80s, another like 30 years.

I was in my late 20s when I witnessed this and it made a huge impression on me, and I've been suspicious of drug pushers ever since.

Which is not to say all medications are unnecessary, but I don't think they're always necessary to the point the pushers say. Each individual must make that decision for themself, depending on their ailment. My individual choice is diet and exercise because I loathe everything about the medical industrial complex.

But I definitely agree that asthma meds and other routine medications for real afflictions shouldn't be prohibitively expensive. That's just greed and why young people are cheering at the killing of that health insurance guy, even though it's misguided and they should really be going after the Big Pharma CEOs.

 

[Clem72]

More like "they know you need it to survive" so you will pay whatever the cost which is 10x more despicable!

You don't need wegovy to survive. If it gets too expensive you can pay for an attendant to slap the doughnuts out of your mouth instead.

 

[GURPS]

Just this last month she was taking a med that was costing her ~$120 per refill. Earlier this week, she went to get a refill and it was now ~$400.

Gov Subsidies cost money
Obama care was supposed to make healthcare CHEAPER .... yeah about that

back those yrs, I posted numerous accounts of progressives complaining how their coverage went up

Well people clap and applaud Biden's Proscription Drug Plans ... sticke'n it to the drug companies ... no the cost just gets paids by others

 

[Clem72]

Gov Subsidies cost money
Obama care was supposed to make healthcare CHEAPER .... yeah about that

What? Who told you that? The only point of that policy was to force more people onto insurance and have the government pick up part of the bill for the poors.

When has forcing people to buy a product and increasing the demand for that product while guaranteeing payment ever drawn the price down?

 

[OccamsRazor]

You don't need wegovy to survive. If it gets too expensive you can pay for an attendant to slap the doughnuts out of your mouth instead.

Pick battles. Not cherries

 

[Squiddie]

As of the new year, my insurance no longer covers Wegovy. Imagine my surprise to see it cost over 700 dollars for one month.
I guess I don't totally get it. It has covered surgeries costing over a hundred thousand and covering weight loss seems to me to be a good return on investment, since an overweight person is probably going to cost more than they pay.
Does anyone else take this?

I highly recommend contacting your insurance company. For lots of insurance companies across the country, they've moved up weight loss drugs like Wegovy to a higher tier to get full coverage. This means that you'll pay more per month in premiums so the insurance company could squeeze more money out of you.

For a lot of insurance companies as well, the deductible you have often resets every year. It's more than likely that either your deductible reset, and you need to meet that deductible before your Wegovy goes down in price, or your insurance has moved it up to a higher tier. Since Wegovy typically costs $1,300 out of pocket, it's more than likely that your insurance has changed the coverage tiers and that your current plan only partially covers your Wegovy.

 

[PJay]

You don't need wegovy to survive. If it gets too expensive you can pay for an attendant to slap the doughnuts out of your mouth instead.

 

[Bobwhite]

I'm probably going to take a lot of heat for this, but here goes.

My observations have been that people who are some level of obese and seek surgical procedures or some form of medication don't want to take responsibility for their health.

1. They don't want to do the hard work that is required to lose the weight, i.e. eating properly and getting more exercise.
2. They want someone or something to do it for them.
3. Of those I've known who had surgery, they didn't follow post surgery instructions and ended up regaining their initial weight loss plus some.
4. Several of them took to drinking way too much alcohol. One man drank himself to death.
5. Some had psychological issues that were never dealt with.

If the insurance companies are seeing these things on a much larger scale, it is not surprising that they don't want to continue covering the cost.

 

[Sneakers]

don't want to take responsibility for their health.

That is def true, but I think (hope) the minority of cases.

 

[Squiddie]

I'm probably going to take a lot of heat for this, but here goes.

My observations have been that people who are some level of obese and seek surgical procedures or some form of medication don't want to take responsibility for their health.

1. They don't want to do the hard work that is required to lose the weight, i.e. eating properly and getting more exercise.
2. They want someone or something to do it for them.
3. Of those I've known who had surgery, they didn't follow post surgery instructions and ended up regaining their initial weight loss plus some.
4. Several of them took to drinking way too much alcohol. One man drank himself to death.
5. Some had psychological issues that were never dealt with.

If the insurance companies are seeing these things on a much larger scale, it is not surprising that they don't want to continue covering the cost.

I don't think this is a bad take.
Weight loss medications like Wegovy and other GLP-1 drugs are great platforms to start off losing weight, but they're by no means a cure to it. Wegovy works primarily by slowing digestion and making you feel more full. It's great to speed up the process of weight loss, because you're eating less, but discipline is still required once you're off of it to prevent stuffing your face again.

 

[Clem72]

I'm probably going to take a lot of heat for this, but here goes.

My observations have been that people who are some level of obese and seek surgical procedures or some form of medication don't want to take responsibility for their health.

1. They don't want to do the hard work that is required to lose the weight, i.e. eating properly and getting more exercise.
2. They want someone or something to do it for them.
3. Of those I've known who had surgery, they didn't follow post surgery instructions and ended up regaining their initial weight loss plus some.
4. Several of them took to drinking way too much alcohol. One man drank himself to death.
5. Some had psychological issues that were never dealt with.

If the insurance companies are seeing these things on a much larger scale, it is not surprising that they don't want to continue covering the cost.

With the caveat that people are different, and their bodies are different. I think we all know that one skinny guy who eats 3x as much as a normal person but never gains a pound. I have always been "a few" lbs overweight, but not terribly so. Growing up, for the most part, I ate the exact same food in the same quantities as my siblings, and I definitely did more physical exercise than my sisters, but I was always the heaviest. Does that mean I couldn't have eaten less and been skinny, no. But it does mean variation of genetics plays some role.

That said, I always find it funny how people demonize the obese but sympathize with drug addicts and alcoholics. Why do you stand up and clap when someone says they are in AA and have been sober for 5 years, but you laugh when someone says they joined jenny Craig and lost 15lbs? Why do you give the drug addict on the corner your spare change, but you point and giggle at the overweight guy trying to use the step machine at the gym?

Some people are too sedentary and despite eating a reasonable amount they slowly gain weight. Others are seriously addicted to food and eat way too much. That second group has trouble with willpower because they can never actually quit. People don't need alcohol to live, they don't need drugs. They do need food. How well would your 5 year sober AA guy do if three times a day he had to drink 1 beer to live? What if you forced the crackhead to smoke 3 rocks per day? How successful would they be?

 

[GURPS]

1. They don't want to do the hard work that is required to lose the weight, i.e. eating properly and getting more exercise.

Some can't

 

[thurley42]

I'm probably going to take a lot of heat for this, but here goes.

My observations have been that people who are some level of obese and seek surgical procedures or some form of medication don't want to take responsibility for their health.

1. They don't want to do the hard work that is required to lose the weight, i.e. eating properly and getting more exercise.
2. They want someone or something to do it for them.
3. Of those I've known who had surgery, they didn't follow post surgery instructions and ended up regaining their initial weight loss plus some.
4. Several of them took to drinking way too much alcohol. One man drank himself to death.
5. Some had psychological issues that were never dealt with.

If the insurance companies are seeing these things on a much larger scale, it is not surprising that they don't want to continue covering the cost.

I'm sure you're probably mostly right.....but there are people who take it for other reasons as well. I'm halfway through getting both of my achilles rebuilt and am using it because I'm used to around 5k cal a day to maintain my weight......so not being able to get much cardio at all it's helping me keep my meals down until I can get back into the gym.

I pay $25 a month for it, but I also pay for really good insurance so I don't have to worry about whether or not I can get something if requested.

To the OP who asked an actual question, I think HIMS and other independent companies like that sell it at a discounted rate, you might want to check there.

 

[GURPS]

With the caveat that people are different, and their bodies are different. I think we all know that one skinny guy who eats 3x as much as a normal person but never gains a pound.

this was me until I hit my 40's and my metabolism slowed down

 

[vraiblonde]

If the insurance companies are seeing these things on a much larger scale, it is not surprising that they don't want to continue covering the cost.

Well, the commercials say "when diet and exercise don't work..." and a lot of people bypass that part and go straight to the shot.

And that's fine, but the weight loss industry is BIG business because everyone wants to eat pizza and fries and still be skinny, but it doesn't work that way even with the drug. Ozempic et. al. were created to treat diabetes, not be a weight loss drug - that's just a side effect and they haven't really studied it enough to know if it's safe. Which is fine - adults can make their own decisions.

But when it was just a diabetes treatment nobody cared; now that it's a weight loss drug EVERYONE wants it and creates a huge demand, which raises the price.

 

[Kyle]

Ozempic et. al. were created to treat diabetes, not be a weight loss drug - that's just a side effect and they haven't really studied it enough to know if it's safe. Which is fine - adults can make their own decisions.

expect there to be a plethora of lawsuits 20 years from now when they find out it causes all sorts of catastrophic side effects or organ failures.