Sanjay Gupta: Is Ozempic Right for You?

In my last post, I discussed the hype around GLP1 drugs for diabetes and weight loss. These are great medicines, but they are no more remarkable than other precision medications like lisinopril, losartan, eplerenone, atorvastatin, metformin, and aspirin that also activate our master genetic survival switch (AMPK) to reduce heart attack and stroke more than they lower the target risk factor.

While I was writing that piece, I watched a special by Dr. Sanjay on the same topic: Is Ozempic Right for You? For most of us, the answer is a firm NO! Health insurance is already unaffordable for families and employers. Medicare will soon run out of money. The national debt threatens our financial security and 136.8 million Americans meet the criteria for at least one of three indications that semaglutide (Ozempic, Wegovy) is currently approved for – diabetes, weight management, or secondary cardiovascular disease prevention. At Walgreens Ozempic costs $1002 a month with a GoodRx card or roughly $12,000 a year. You may not pay that, but your employer or the government is making up the difference. That is $1,641,600,000,000— $1.64 trillion dollars in added healthcare cost.

Here is the latest information from the American Diabetes Association on the cost of treating type 2 diabetes: “The total estimated cost of diagnosed diabetes in the U.S. in 2022 is $412.9 billion, including $306.6 billion in direct medical costs and $106.3 billion in indirect costs attributable to diabetes. For cost categories analyzed, care for people diagnosed with diabetes accounts for 1 in 4 health care dollars in the U.S., 61% of which are attributable to diabetes. On average people with diabetes incur annual medical expenditures of $19,736, of which approximately $12,022 is attributable to diabetes.” You can clearly see at a glance that the direct costs of treating diabetes are doubled simply because Ozempic is added to the treatment regimen. We can’t afford it. You can’t afford it.  

Doubling the cost would be rational if it resulted in a huge leap in efficacy, but that is not the case. Optimal medical therapy for type 2 diabetes is defined by achieving 5 goals using best practice interventions: blood pressure control, glucose control, cholesterol lowering, clot prevention with aspirin in high-risk patients, and not smoking. As we have discussed, you must treat 111 patients with Ozempic to prevent a major cardiovascular event, while you only need to treat 5 with optima medical therapy (OMT) to prevent one. You can see the drugs in our OMT protocol in the diagram at the beginning of this article. Even if you have high blood pressure that is difficult to control and need all the anti hypertensive medications, the monthly cost for this protocol is only $49. OMT is over 20 times as effective and one twentieth the cost. If you are serious about better health at lower cost, your members and patients must use OMT first. If you use the OMT protocol early enough, you will never need Ozempic.