Very Expensive Diabetes Drugs Threaten Your Job
High Medical Care Costs are One of the Reasons We Lost Manufacturing Jobs
High healthcare costs are part of the reason so many manufacturing jobs left our country. When GM spends more on healthcare than it does on steel, that puts them at a competitive disadvantage. Average healthcare spending per person in other wealthy countries is about half of what we spend in the US. It is even less in the poorer companies where many jobs go. Many US jobs are going to Mexico. They spend about $1200 per person per year. In our country, “Average annual health insurance premiums in 2023 are $8,435 for single coverage and $23,968 for family coverage. These average premiums each increased 7% in 2023. The average family premium has increased 22% since 2018 and 47% since 2013.” We are all worried about the price of gas and eggs, but a single serious illness or accident can bankrupt your family. One of the main drivers of these very high costs are very expensive new brand name drugs like Wegovy for chronic diseases. In chronic diseases like type 2 diabetes, the value is just not there.
The drug company Novo Nordisk makes Wegovy in Denmark. In Denmark, Wegovy costs $340 a month there. In the United States, if you buy Wegovy at Walmart without health insurance, you will pay $1406 a month. You are being ripped off because the United States government does not negotiate drug prices except for ten medications. Even at a price of $340 a month, this drug is very expensive. In other developed countries it costs much less. Wegovy is $93 in the Great Britain, $87 in Australia, and $83 in France. Danish authorities are pushing back hard. At $340 a month, it costs $870,000 to prevent one cardiac event. At US prices it would cost $3,597,450. That is ridiculous on the face of it. Wegovy is a good drug but we are crazy to pay what we are paying.
In patients with type 2 diabetes and chronic kidney disease, the medication in Wegovy lowered major cardiovascular events by 18% over three and a half years. Optimal medical therapy (OMT) is a more powerful approach to the same problem. OMT does not merely address obesity and sugar levels. It is a multifactorial intervention that aggressively controls type 2 diabetes, high blood pressure, and high cholesterol with proven generic drugs that protect cells and organs with antioxidant and anti-inflammatory effects while lowering the target risk factor. OMT lowers the risk of cardiovascular events by 59%. That is over three times the impact of Wegovy.
Your doctor or other clinician needs effective medications to protect you from the ravages of obesity and type 2 diabetes. The components of OMT are much less expensive than Wegovy. Here are the actual medicines that were used to reduce cardiovascular events three times as much as Wegovy two decades ago. I have included their current prices with no insurance at Walmart.
Lisinopril ($4), amlodipine ($13), and hydrochlorothiazide ($4) for high blood pressure.
Atorvastatin ($16) for high cholesterol
Metformin ($4) for diabetes.
Even if you need all three hypertension drugs to control your blood pressure, the cost is only $41 a month.
OMT is three times as effective as Wegovy in preventing cardiovascular events. If you divide $870,000 to prevent a cardiovascular event by three, that is still very expensive at $290,000. Wegovy is thirty-four times as expensive as the five drugs that were used for OMT. So, your divide $290,000 by thirty-four. Now you have knocked down the price to prevent a cardiovascular event to $8,500. and that is less than the cost of the events themselves.
Blocked leg artery: $33,700
Heart attack: $29,500
Heart artery disease: $29,900
Atrial fibrillation: $13,100
There are two ways we can improve this very quickly. First, most people in the United States don’t have access to OMT and we can scale that quickly with the right policy adjustments. Second, we absolutely need to negotiate drug prices. Medications are the products your clinician uses to protect you from the increased risk of heart attack, stroke, and kidney failure in type 2 diabetes. Every business negotiates the prices of the products and materials they use. Of course, GM negotiates the price of steel. Of course, Starbucks negotiates the price of coffee. Walmart buys direct from the producer and negotiates the price of everything they sell. They would be crazy not to. There is no way for you to know what your insurance company pays for Wegovy. It would be very hard for you to find all these facts and the relative benefits of different medical approaches. You have no control over any of this and the usual market dynamics don’t work in medicine. The arrangements are all secret and there are too many people with a hand in the cookie jar. There are federal laws that don’t allow drug price negotiation. Those laws must change.
Wegovy is almost $17,000 a year. On average people with diabetes incur annual medical expenditures of $19,736. If you add Wegovy cost to that, the total cost is $36,000. That nearly doubles the cost of treating diabetes. People with diabetes have medical expenditures two and a half times as high as others even without Wegovy. If you are employed by a town, county, or school district these costs are unsustainable. Every American has skin in this game. If you have type 2 diabetes, encourage your employer or community to make OMT available to you.
A well written article. Thank you.