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Dec 13, 2023Liked by Jeremy Faust, MD

My husband is on Ozempic for diabetes that suddenly became very poorly controlled: it's been amazing and he's had significant weight loss. His PCP and me (a family doc) have debated how to take the least amount of the medication as his numbers have normalized. There is absolutely no data on the .25 dose which the company claims doesn't work on hyperglycemia but observation says it does. An off ramp or downward taper is needed. And to make all the doses the same price is just price gouging.

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I’ve never understood that weirdness of pricing. Sure the injection is a fixed cost but that is not why it’s 13k per year!

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Another option: try spreading out the doses. How sure are we that 7 days is the magic number? A patient could mark the calendar, take the drug every 8 days, every ten, etc. At every two weeks they’ll be spending half as much, and their weight may oscillate by 1-2% instead of 10%.

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Yes this is great point.

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founding
Dec 13, 2023Liked by Jeremy Faust, MD

I totally agree with your points on current obesity drugs however don’t know a single friend or family member that was told to come off a hypertensive med, statin or blood sugar med when numbers were within normal range. I suspect most doctors believe the numbers look good because of the drug. More research here too.

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I’ve seen it. It’s not common. But it happens!

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I think one aspect you are inadvertantly missing (which fundamentally supports your argument) is that weight loss patients are advised to shift to a maintenance dose for these medications once they hit their weight loss goal. This is typically a lower dose spread further apart. I agree that more studies are needed to see what is the optimal plan for maintenance (it likely is not a one-size-fits-all approach), and ideally it would be the minimum dose spaced furthest apart to help with both side effects and costs. However amazing these medications are, they have yet to prove themselves as a "cure" for obesity, but they are indeed an incredible and effective treatment option.

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Yeah you are right that I forgot about the lower maintenance dose.

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