The Ozempocalypse Is Nigh

Astral Codex Ten Podcast

Sorry, you can only get drugs when there's a drug shortage.

Three GLP-1 drugs are approved for weight loss in the United States:

• Semaglutide (Ozempic®, Wegovy®, Rybelsus®)
• Tirzepatide (Mounjaro®, Zepbound®)
• Liraglutide (Victoza®, Saxenda®)

…but liraglutide is noticeably worse than the others, and most people prefer either semaglutide or tirzepatide. These cost about $1000/month and are rarely covered by insurance, putting them out of reach for most Americans.

…if you buy them from the pharma companies, like a chump. For the past three years, there’s been a shortage of these drugs. FDA regulations say that during a shortage, it’s semi-legal for compounding pharmacies to provide medications without getting the patent-holders’ permission. In practice, that means they get cheap peptides from China, do some minimal safety testing in house, and sell them online.

So for the past three years, telehealth startups working with compounding pharmacies have sold these drugs for about $200/month. Over two million Americans have made use of this loophole to get weight loss drugs for cheap. But there was always a looming question - what happens when the shortage ends? Many people have to stay on GLP-1 drugs permanently, or else they risk regaining their lost weight. But many can’t afford $1000/month. What happens to them?

Now we’ll find out. At the end of last year, the FDA declared the shortage over. The compounding pharmacies appealed the decision, but last month the FDA confirmed its decision was final. As of March 19 (for tirzepatide) and April 22 (for semaglutide), compounding pharmacies will no longer be able to sell cheap GLP-1 drugs.

Let’s take a second to think of the real victims here: telehealth company stockholders.

https://www.astralcodexten.com/p/the-ozempocalypse-is-nigh