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Heading into a gluttonous time of year in the U.S. with Halloween, Thanksgiving and Christmas on deck, it might be a bad time for Americans to find out their obesity rates continue to climb.
Based on a two-year survey of roughly 6,000 people, the U.S. Centers for Disease Control’s latest report on the prevalence of obesity puts the rate at about 40 per cent, slightly higher in women than in men, with more older people considered obese than young. The rate of severe obesity — defined as having a body mass index (BMI) of 40 or more — clocked just below 10 per cent; however, the data also shows the age-adjusted prevalence of severe obesity over 10 years increased by two per cent.
By comparison, the most recent Canadian Community Health Survey, conducted in 2022, sets the obesity rate for Canadians 18 and older at 30 per cent, about the same across men and women. Twenty years prior, Statistics Canada says the rate was closer to 21 per cent.
But as obesity rates climb, a new and highly effective weight control tool could be in shorter supply.
On Tuesday, The Washington Post reported that some patients taking drugs like Wegovy and Zepbound — along with Ozempic and Mounjaro, also used for weight loss, though tailored to diabetics — have been navigating a world in which the drugs are in higher demand and harder to get.
The medications, which mimic a hormone responsible for regulating blood sugar levels and suppressing appetite, are drugs that users will need to take forever. Stop taking them and the weight comes back.
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In a section dedicated solely to answering supply-related questions related to Wegovy, arguably the most widely prescribed and used of the drugs on the market, drug maker Novo Nordisk said “total weekly prescriptions have more than doubled compared to the beginning of the year.”
“It is important to recognize that overall demand will continue to exceed supply,” the statement reads.
Health Canada approved Ozempic for use in Canada in 2018, with Mounjaro’s approval coming in 2023. An update from the government agency in June cited continuing supply issues, noting that the provider expected shortages to be resolved by year end.
Wegovy was approved in 2021 but, due to supply issues, it didn’t show up in Canada until this May.
Shortages of the drug were already being noticed by Ozempic-taking North Americans with Type 2 diabetes, many who found themselves challenged with maintaining a prescription as the drug’s weight-gain properties became well known and well documented.
A different kind of shortage related to the drugs has been felt in South Africa where, as reported by The New York Times, Nova Nordisk didn’t renew its contract to provide insulin pens, which use the same single-use technology employed for Ozempic and Wegovy. It’s left some diabetics there reverting to drawing their insulin the old-fashioned way, using vials and syringes.
In Washington on Tuesday, Novo Nordisk CEO Lars Jørgensen sat before a congressional hearing asking him to explain why Ozempic and Wegovy cost more in the U.S. compared to other countries.
The committee cited a US$969 monthly cost for U.S. patients — but more than $1,300 for those with obesity — compared to US$155 for Canadians and a mere US$59 per month in Germany. Insurance and rebates tend to knock down the U.S. price considerably.
During the hearing, Vermont Senator Bernie Sanders pleaded with Jørgensen to “Stop ripping us off.” The CEO, in response, talked about their expansion efforts but ultimately blamed the country’s complex health-care system, according to ABC News.
In a detailed written testimony submitted by Jørgensen before the single-day hearing, the CEO cited post-insurance figures at US$25 and US$50 per month. But he explained at length how U.S. health care “middlemen who play a key role in both patient access and cost” — pharmacy benefit managers (PBMs) — exert broad control over what can be available and for what price.
PBMs advise insurers on structuring pharmacy benefits, usually making money at every stage of the drug supply chain.
“The PBMs’ customers … are often their own corporate parent healthcare conglomerates — not American patients,” Jørgensen charged. “In practice, this means that PBMs negotiate large undisclosed payments from drug manufacturers that lower the price of medicines, called ‘rebates,’ that they then provide to their corporate affiliates, rather than applying those dollars to lower the cost actual patients pay for their medications at the pharmacy counter.”
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