Weight Loss Medications Are Effective, and Expensive
There are options, however, for those who need them that are considerably less expensive.
By Dr. Joseph Ferguson
COLUMNIST
Editor’s Note: This column by a local medical professional offers insights and advice on medical topics. The opinions or views expressed in these columns are not intended to treat or diagnose; nor are they meant to replace the treatment and care that you may be receiving from a licensed professional physician or mental health professional.
Breaking News: Weight Loss Medication Now Available at a Drastically Reduced Cost: Liraglutide for $74 a Month instead of $1,000 a Month!
If you haven’t been living in the forest as a hermit, you probably know that there are weight loss medications out there that are getting a lot of attention. If you’ve investigated the possibility of trying one of those weight loss medications, you may have concluded that the medications are reserved for the wealthy.
I recently saw a patient who had gone to a weight loss clinic to get one of those medications and she told me she was required to pay $3,000 up front. In this article, I will discuss these popular medications with an emphasis on explaining how it is possible to obtain them at a greatly reduced cost.
The two weight loss medications that have gotten the most press are semaglutide and tirzepetide. Both are in a class of medications called GLP-1. Rybelsus is a daily tablet of semaglutide and is the only GLP-1 that is not injectable. Liraglutide is the only injectable that is once daily. The other injectables are once weekly.
It is my opinion that all of the GLP-1 hype is well-deserved. I graduated from medical school 30 years ago and I have been prescribing medications for weight loss for 30 years. GLP-1 medications are far more effective than any other weight loss medications that I have ever prescribed. I expect my patients on GLP-1 medication to be losing five to ten pounds per month, and many haven’t slowed down with their weight loss at month twelve.
Truly, I have patients for whom GLP-1 medication is just as effective as weight loss surgery.
The two brand names for injectable semaglutide are Ozempic and Wegovy. Both Ozempic and Wegovy are made by the same pharmaceutical manufacturer in the same factory, and they are identical in all ways except for their labeling and their marketing. Ozempic is marketed for diabetes and Wegovy is marketed for weight loss. In the same fashion, tirzepatide is marketed as both Mounjaro and Zepbound, where Mounjaro is marketed for diabetes and Zepbound is marketed for weight loss, but both are otherwise identical and made in the same factory.
All medications mentioned in the previous paragraph cost about $1,000 per month and insurance companies are not happy about paying that kind of money. Even insurance companies that do pay for those medications often have elaborate procedures in place that are designed to make it difficult for people to obtain the medication. So people with enough money often just pay the $1,000 per month. And even when insurance agrees to pay for a GLP-1 medication, the monthly copay can be over $200. Copays can sometimes be greatly reduced with coupons, but Medicare patients are not allowed to use those coupons.
How to Get GLP-1 Medications for Less
One option is to go through a Canadian online pharmacy. One of my patients uses canadapharmacy.com. They sell a one-month supply of Ozempic for $425 and two months for $790, which works out to $395 per month.
Semaglutide and tirzepatide have been so popular that the pharmaceutical manufacturers have not been able to keep up with demand. The FDA therefore decided to temporarily remove patent protection and allow compounding pharmacies to sell versions of those medications.
Compounding pharmacies have been buying bulk semaglutide and tirzepatide from manufacturers, mostly in India and China, and they have been selling vials or tablets of those medications at a reduced cost. The FDA recently decided that the shortage of those medications is over, so they reinstated patent protections for the pharmaceutical companies, which means that the compounding pharmacies are supposed to stop selling their versions of semaglutide and tirzepatide.
A patient of mine who has been getting her tirzepatide from a compounding pharmacy told me that the pharmacy will no longer be selling compounded GLP-1 medications. Nonetheless, I expect that some compounding pharmacies will continue to sell their versions of semaglutide and tirzepatide in violation of patent law. If you want to get a medication from a compounding pharmacy, just do a search using the name of the medication you want. You can expect to pay a few hundred dollars per month. You may even want to buy as much as six months of medication so you can get it before the gravy train is shut down for good.
And that brings us to liraglutide, which is the main point up to which I have been leading. It has the disadvantage of being a once daily injection instead of once weekly, but its cost is significantly reduced. And maybe once daily dosing isn’t such a bad thing.
A patient of mine who switched from semaglutide to liraglutide told me that he didn’t think the semaglutide really lasted a week with him since he sometimes would find himself binge eating a day or two prior to his weekly dose. After the switch to liraglutide, his weight loss sped up.
Liraglutide is a GLP-1 that has been around long enough that patent protection has recently run out, so generics are now available. Its brand name versions, which cost $1,000 per month, are Victoza, marketed for diabetes, and Saxenda, marketed for weight loss.
Using the prescription savings coupon, GoodRx, which anyone can use, a two month supply of liraglutide sells for $258.32 at CVS, which is the lowest price in Fredericksburg. But the GoodRx price for that same two month supply is $139.62 at Rite Aid, the nearest of which is on Broad Street in Richmond. It sells for $164.40 at Safeway, which has a lot of locations in northern Virginia, the closest of which being in Warrenton and Dale City. Patients of mine who live or work north or west of Fredericksburg tend to go to Safeway and the rest tend to make the trek down to Richmond.
A two-month supply of liraglutide for $139.62 is $69.81 per month, which is pretty good compared with $1,000 per month. But you will also have to buy needles for the liraglutide pen. You can get a box of 90 needles for about $12 which is $4 per month, so that gets you up to about $74 per month. And you might also want to take into account money spent on gas and how much your time is worth and how much of that time is spent on a trip to Richmond.
I should also mention that some insurance companies that refuse to pay for semaglutide and tirzepatide will actually go ahead and cover liraglutide. Also, if you have a $200 copay for semaglutide or tirzepatide, your copay for liraglutide would likely be a great deal less.
So what would I do if I wanted to try out a GLP-1 medication? I would first request that my primary physician prescribe Wegovy or a similar medication. If my insurance covered it and my copay were reasonable, that would be my route. Otherwise, I would request a prescription for liraglutide and I would go to the Rite Aid on Broad Street in Richmond.
If you are serious about losing weight, I strongly recommend that you try a GLP-1 medication. And maybe it’s realistic to do so, now that you know how to do it without breaking the bank.
Joseph Ferguson, MD, is a graduate of The John’s Hopkins School of Medicine. He founded Fredericksburg Primary Care 20 years ago and he has operated that clinic ever since. His office is accepting new patients at: 540.374.8140.
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