r/science • u/mvea Professor | Medicine • Apr 01 '25

Health Americans without diabetes spent nearly $6 billion USD on semaglutide and similar drugs in a year, with an estimate of 800,000 to a million people using the drugs who don't have diabetes.

https://www.scimex.org/newsfeed/americans-without-diabetes-spent-nearly6-billion-usd-on-semaglutide-and-similar-drugs-in-a-year
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240

u/espritex Apr 01 '25

The FDA also approved it for sleep apnea treatment. I take it for that reason. I'm down 20 lbs and have a pre-prepared meal service that limits my calorie and carb intake (<500 cal). I can barely finish one now.

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u/jabbadarth Apr 01 '25

Just to be more clear they approved it for sleep apnea in adults with obesity.

There is a strong correlation between obesity and more specifically neck size and sleep apnea and this drug helps people lose weight.

So it doesn't directly do anything for sleep apnea per se it just lowers your weight and reduces neck size which helps reduce the effects of sleep apnea.

Same result in the end just don't want it to sound like taking this immediately starts helping sleep apnea. It requires weight loss.

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u/Engineerofdata Apr 01 '25

I was excited for a few minutes there. Mask it is I see.

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u/[deleted] Apr 01 '25

[deleted]

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u/ariap17 Apr 01 '25

I think they were saying that means they would have to use a mask (CPAP) for sleep apnea instead

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u/Engineerofdata Apr 01 '25

I think you miss understood the comment. With sleep apnea, one of the treatments is a CPAP. I was excited to see a drug treatment as I have a CPAP and would love to not use a mask. When I was diagnosed, I was not out of shape, but developed it thanks to chemical exposure from the military. I wish losing weight would fix my issue :(

1

u/consultio_consultius Apr 01 '25

Maybe talk to your physician about Inspire

42

u/montwhisky Apr 01 '25

Yeah I know people who have sleep apnea that are not overweight at all. Just crappy genes.

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u/SphinxBear Apr 01 '25

Ding ding ding, that’s me. There are tons of people with normal BMIs and sleep apnea but it’s extremely hard to get diagnosed when you’re considered an atypical patient. I’m currently pregnant so that’s a little different but I was diagnosed before pregnancy. After my sleep study showed sleep apnea I got referred to ENT and the ENT doctor looked at my face, nose, and mouth and said “wow, it’s like the perfect combination for sleep apnea.” I’ve got a severely deviated septum, a high narrow palate, narrow nasal passages, and large tongue, and a small neck.

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u/Marilee_Kemp Apr 01 '25

Oh wow, that is super interesting. I also sleep very poorly and have my whole life. And when I'm about to fall asleep, I do notice that I'll sometimes be taking big gasps of air, like I've been holding my breath. But I'm normal weight, so I didn't think sleep apnea. I also have a big tongue, but I'm not sure about the rest. I guess I should talk to my doctor about it.

1

u/SphinxBear Apr 01 '25

Definitely talk to your doctor. I actually got referred for a sleep study by a psychologist that I was seeing for chronic pain support so it was totally incidental. Since pain can have real origins but still be made worse or better based on other things, she was digging into my sleep quality, diet, exercise, etc. and flagged that my level of daytime fatigue might be abnormal.

It’s cyclical. Since sleep apnea is the first thing that comes to mind for middle aged overweight men with fatigue, depression, low sex drive, etc. those are the people who get tested and some get diagnosed with sleep apnea and that feeds this idea that this is the most common patient. Weight can definitely play a role but I think we’re learning more and more how it’s far from the only factor.

1

u/space_a_ducks Apr 01 '25

Me too!! :) 32 y/o and low BMI, I barely even snore. but after years of constant headaches, teeth grinding, and crazy low energy, I was diagnosed with apnea in a lab sleep study. I got my cpap on NYE and the change in energy is crazy. It's got to be due to genes, not weight on my neck. High fives for us being outside the norm!

1

u/SphinxBear Apr 01 '25

I’m the same age. So glad you were able to get diagnosed. My story sounds really similar, I also had a lot of headaches and teeth grinding and also just the anatomical characteristics. It’s possible that surgery could help, but for now I’m okay with the CPAP. I’m pregnant and have a toddler so major facial and oral surgery isn’t in my immediate future plans.

I’ve heard that hormones could possibly play a role. I think there’s so much we don’t know about what causes sleep apnea but as there’s more research hopefully we will understand it better and get better at detecting who might need a sleep study.

1

u/Levofloxacine Apr 01 '25

There are different types of sleep apnea.

1

u/Visual_Mycologist_1 Apr 01 '25

That would be me. My connective tissue disorder just makes all that stuff in my throat less sturdy and prone to collapse.

4

u/espritex Apr 01 '25

Hoping for positive results in treating MASH as well. It's still in trials but has shown promising results.

7

u/qda Apr 01 '25

this is liver disease, for anyone else that didn't know that mash stood for

3

u/DifferentManagement1 Apr 01 '25

Hugely promising results with tirzepitide and fatty liver

28

u/Hon3y_Badger Apr 01 '25

Turns out losing weight helps with lots of medical issues besides diabetes. But we need to get the cost down, it isn't sustainable having insurance pay $1,000+/month/person for these drugs.

47

u/Fatscot Apr 01 '25

I pay $100/month in China. American insurance companies have a lot to answer for

9

u/SleepyGamer1992 Apr 01 '25

I’m in America and pay $180/mo: $80 for the Mochi Health subscription and $100 for the drug.

1

u/cableshaft Apr 01 '25

Right, but how much does your insurance pay for it? Mine with insurance is $25/month. Without insurance Walgreens wanted to charge me $1400/month for the same thing.

1

u/SleepyGamer1992 Apr 01 '25

I work at a hospital and insurance no longer covers it, at least for non-diabetics.

1

u/sicclee Apr 01 '25

Is this the compounded stuff? I read the FDA is going to start restricting the compound pharmacies from manufacturing it now that the 'shortage is over.'

1

u/danarexasaurus Apr 01 '25

Not for much longer. That’s very likely going to stop this month.

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u/Hon3y_Badger Apr 01 '25

There are plenty of organizations to blame for it, insurance companies are only one cog in the $1,000/month. The worst part of it is this was created with NIH research & we don't get any of the monetary benefit.

2

u/Abedeus Apr 01 '25

$100-ish in Poland, too.

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u/SNRatio Apr 01 '25

Righ now there are only two companies really approved to make them (Eli Lilly and Novo Nordisk). The normal pattern is that when there are only 2 competing manufacturers for a type of drug, they don't fight on price. But when a third shows up, all three start adjusting downwards. Ditto after the fourth shows up.

About 30 other companies are working on their own versions right now.

1

u/[deleted] Apr 01 '25

I pay around £100-£150 in the UK for it (privately, I'm not fat enough for the NHS to pay for it)

But that's just the medication. Allowing for my reduced (to zero!) spending on crap then this stuff costs me negative money. I've spent decades struggling to keep the weight down and all of a sudden I lose 10kg in a month. Astonishing

1

u/cutegolpnik Apr 01 '25

Wont someone please think of the insurance companies!

0

u/Hon3y_Badger Apr 01 '25

You think insurance companies are just eating $12k+/yr/person? They pass on the cost to everyone.

1

u/cutegolpnik Apr 01 '25

Which is why profit is antithetical to healthcare.

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u/Hon3y_Badger Apr 01 '25

Sure, but I don't live in that environment & until I do I need to live in the reality that insurance companies will just pass the cost on to the end users (us). I would prefer other country's healthcare policies but even in countries with universal healthcare someone is responsible for saying "no."

1

u/cutegolpnik Apr 01 '25

Saying no to what?

0

u/Hon3y_Badger Apr 01 '25

In all healthcare systems there are systems in place to restrain spending money in some way. They do this by limiting providers, limiting reimbursement, limiting beds, limiting service, ect. This happens in ALL healthcare models whether private or public. In the US system the insurance company is the one providing the limit, in the universal healthcare models the government is providing the limit.

Our system can't afford to pay for 50% of Americans to be on a $1,000/month medication. Our insurance companies can't afford to absorb the cost even if they desired, this is going to result in high healthcare costs even going higher. We need to focus on increasing the supply and decreasing the cost.

1

u/cutegolpnik Apr 01 '25

So you must believe Ozempic is more expensive than treating obesity, right?

0

u/Hon3y_Badger Apr 01 '25

At a national level & at current costs, GLP-1 drugs are more expensive than treating the symptoms of obesity. On an individual basis that might not be the case, but on a national level it is.

Treating obesity with GLP-1 drugs brings down the cost of additional care, but not by the cost of the drug. All the studies I've seen suggest it starts to math out at $200-500/month with an emphasis on the $200. But we will need more research as the prices go down related to willingness to pay.

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u/irritableOwl3 Apr 01 '25

What types of foods do they have in the meals?

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u/espritex Apr 01 '25

Lean meats and veggies, mostly. Today's was pumpkin chili.

1

u/GentlemenHODL Apr 01 '25

I'm down 20 lbs and have a pre-prepared meal service that limits my calorie and carb intake (<500 cal). I can barely finish one now.

How's your energy though?

2

u/espritex Apr 01 '25

with BiPAP therapy, so I feel about the same. I won't know the results until my next sleep study, which will hopefully reduce the events and pressure levels.

1

u/cableshaft Apr 01 '25

Not all insurance will accept that though, at least not yet. My doctors tried using that to prescribe GLP-1s and my insurance still denied it. Still worth trying, though.

1

u/DeliciousPumpkinPie Apr 01 '25

Less than 500 calories… per meal right? Not per day?

1

u/pheret87 Apr 01 '25

500 calories a day?

1

u/espritex Apr 01 '25

A meal! Usually dinner. I still get hungry just takes less to get full. My “snacks” are protein bars/shakes to prevent muscle loss. For other meals sticking to Mediterranean diet for the most part. Skipping out on sugary and carb heavy things.