In this lesson, we explore one of the biggest health stories of the moment: new weight-loss drugs. These medicines, known as GLP-1 agonists, are incredibly effective but also very expensive. This creates a difficult question for societies around the world: Who gets access to them, and who should pay? We'll look at this issue as a case study in how health policy is made.
How do drugs like Ozempic work?
A short video explaining the science behind new weight-loss medicines.
Video Transcript
The drug semaglutide is formulated to help people with type 2 diabetes control their blood sugar. Sold as Ozempic for diabetes, semaglutide is also approved as a weight-loss drug under the brand name Wegovy. Both medications are self-administered once a week with an auto-injector. [ 00:15 ]
Ozempic and Wegovy are glucagon-like peptide-1, or GLP-1, agonists. This means that they stimulate the production of incretin, a naturally occurring hormone that helps people feel full longer by slowing the rate the stomach empties. Incretins also impact the hypothalamus, a part of the brain that controls hunger signals, reducing hunger and cravings. [ 00:40 ]
A clinical trial conducted by the drug maker Novo Nordisk found that over the course of a 68-week study, those who took Wegovy lost 14.9 percent of their body weight. Those who received the placebo control lost just 2.4 percent of their weight. [ 00:56 ]
Because of how semaglutide affects the stomach, gastrointestinal side effects such as nausea and vomiting are possible. And once a patient discontinues semaglutide use, weight that has been lost can return. [ 01:09 ]
Wegovy is the only weekly GLP-1 treatment approved for weight loss, but competition is coming. Eli Lilly has a drug which is expected to win approval this year, and Amgen, Pfizer, and others are developing rival drugs that promise less frequent dosing, more substantial weight loss, or fewer side effects. [ 01:28 ]
Hook: A Question of Cost
Think / Pair / Share
With a partner, discuss the following question. Be prepared to share your main ideas with the class.
Question: A new medicine can prevent a serious future illness (like a heart attack), but it costs thousands of dollars per year. Who do you think should pay for it?
- The patient who needs it?
- Private insurance companies?
- The government (public healthcare system)?
- The patient's employer?
Read: Decoding the Headlines
Read the two short texts below. They are adapted from official sources in the United States and explain a recent major change for a popular GLP-1 drug called Wegovy.
As you read, find and highlight:
- Two important statistics or numbers from the first text.
- Two limitations or constraints on who can get the drug covered from the second text.
FDA Approves First Treatment...
Source: U.S. Food and Drug Administration (FDA) Press Release, March 8, 2024
Today, the U.S. Food and Drug Administration approved a new use for Wegovy (semaglutide). In addition to weight management, it is now approved to reduce the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease who are also obese or overweight.
The drug’s effectiveness was studied in a trial of over 17,600 participants. Some received Wegovy and others received a placebo. A smaller proportion of participants experienced a major adverse cardiovascular event (MACE) in the Wegovy group (6.5%) compared to the placebo group (8.0%). This shows a clear risk reduction.
Medicare Coverage of New Weight-Loss Drugs
Source: KFF (Kaiser Family Foundation) Policy Summary, Spring 2024
Following the FDA’s new approval, the Centers for Medicare & Medicaid Services (CMS) confirmed that Medicare Part D plans (which cover prescription drugs) can cover Wegovy for patients who meet the specific criteria.
However, coverage is not automatic. There are two important constraints. First, the drug can only be covered for its cardiovascular risk-reduction use, not just for weight loss. Second, each private insurance company that offers a Part D plan decides for itself whether to include Wegovy on its list of covered drugs (its "formulary"). As a result, coverage and patient costs—like deductibles and co-pays—will vary significantly between different insurance plans.
Language Lab: Making Recommendations
When discussing policy, we often need to make recommendations. We use modal verbs like should and phrases like it would be wise to for giving strong advice.
Form
| Subject + should + base verb |
| Subject + would be wise to + base verb |
"The government should cover the cost for high-risk patients." (This is a direct recommendation.)
"It would be wise for insurers to negotiate a lower price before covering the drug." (This is a more formal, strategic recommendation.)
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