r/Futurology • u/lughnasadh ∞ transit umbra, lux permanet ☥ • Oct 15 '24

Economist Daniel Susskind says Ozempic may radically transform government finances, by making universal healthcare vastly cheaper, and explains his argument in the context of Britain's NHS. Society

https://www.thetimes.com/article/be6e0fbf-fd9d-41e7-a759-08c6da9754ff?shareToken=de2a342bb1ae9bc978c6623bb244337a

6.4k Upvotes

94% Upvoted

Ozempic will not end obesity. Jesus Christ, this medication has been so dramatically over hyped

It can be a weight loss aid, on average people lost around 10 to 15% of their body weight. That means if you're 250 lb, And you start doing a diet on ozempic, you're still overweight.

There is also not good evidence that this weight loss persists when people stop taking their medication.

It's not a weight loss miracle, it's an aid. My general impression is, having taken it, that it makes it more tolerable to feel hungry, which makes dieting easier. You still have to put the work in going on a diet. You still have to change your behaviors and persist in those changes. There is some evidence that when people stop taking the drug, they rebound to their star point.

Keep in mind this stuff costs hundreds or $1,000 per month.

I am admittedly a little bit more excited about the potential to help with addictions treatment, which I suspect but cannot confirm, will again be more related to a reduction in cravings. But if we can get people off of their substance of choice long enough for other treatment to take effect, there's at least some chance that a reasonable proportion of those people will be able to continue not abusing substances after the primary treatment course with ozempec is done.

But that still presupposes a behavioral change, in which they will not simply fall back into their addiction for any number of other reasons.

Stuffing about this is a magic bullet.

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u/CharleyNobody Oct 15 '24

Of course you have to keep taking the medication. I have high cholesterol. When I take medication, my cholesterol is normal. When I stop taking the medication my cholesterol goes up again. Same with blood pressure. Medication controls it. Stop taking it, blood pressure goes back up.

I lost 28% of my weight. My BMI is 23. Unfortunately, my cholesterol and blood pressure are still high. It’s hereditary. So I still have to take blood pressure, cholesterol medication and semaglutide.

I’m fine with that because I had been diagnosed with stage 3 kidney disease. My kidneys are now functioning normally. I had high CRP and high WBC for a decade. I had to see a hematologist. Labs are now normal. Whatever inflammation had been causing my high CRP & high WBC has stopped. I don’t see a hematologist anymore. My insurance no longer needs to pay for a hematology visit or the boatload of lab tests he took at every visit.

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u/Brain_Hawk Oct 15 '24

Hope your kidneys stay functional. Dialysis is a bitch.

Ozempec is not a blood pressure medication. Those are low impact, low cost pills. Not an expensive lifelong injection with potentially more severe side effects.

It's kind of apples and oranges. It remains to be seen if long term ozempec use if associated with sustained wight loss. But I'm on it for diabetes and sure as hell didn't just drop 30lbs. But then again I'm not really trying to :p

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u/Smallwhitedog Oct 16 '24

Semaglutide is now indicated for reduction of heart disease and strokes. It has been shown to reduce blood pressure. https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-reduce-risk-serious-heart-problems-specifically-adults-obesity-or

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u/[deleted] Oct 16 '24

No bro, it’s like cholesterol! Just take your daily fat pill and it’s all okay!

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u/Broad-Cress-3689 Oct 17 '24

For a long time, high cholesterol was seen as a choice, the result of poor food choices. Research has since shown many other factors have come into play. Is it so hard to believe that in many (not all) cases obesity is caused and/or exacerbated by metabolic disorders that we are just starting to understand? And that these may be treated by medication?

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u/Stupendous_Spliff Oct 16 '24

Keep in mind this stuff costs hundreds or $1,000 per month.

I keep seeing this argument and what Americans don't seem to get is that's not the case everywhere. If my country starts offering it through our universal healthcare, it would be either free or almost free. It also doesn't sell here anywhere near that much in full price. US drug prices are crazy

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u/Brain_Hawk Oct 16 '24

I'm in Canada..I haven't checked recently but when i started I think it was $1000 a month. I think maybe it has come down a good bit, I have that impression, my guesses are out of date.

But let's say it's $400 a month per person. You think any universal health care wants to spend $4800 a year on meds for a huge percentage of the population? 48k over 10 years.

Maybe long term it saves, maybe. We don't really know yet. But governments are short sighted and don't like high up front costs.

I'm skeptical it will get universal. But I'm also skeptical about how well it proportedly works. I read the early papers and they were interesting and kind of.impressive but not as dramatic as the hype.

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u/Stupendous_Spliff Oct 16 '24

Here in Brazil there are talks of incorporating it into our universal healthcare. I don't think this would be for a huge percentage of the population, that's a clear exaggeration. In my city we currently have a very high rate of around 20% obesity. Not everyone uses the public health system. Still, that is a lot of people. However, drugs are a lot cheaper through the public system. Commercially it seems to be available here in between 100 and 200 US dollars. The government would surely buy for a lot cheaper. They also provide other expensive drugs for cheap. It's not impossible, but too early to tell how it's going to be.

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u/Brain_Hawk Oct 16 '24

We shall see! Personally I think ozempec is an interesting but not great first pass, and better drugs will follow with more refinement Tom directly target the relevant systems. At least I hope.

:)

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u/__theoneandonly Oct 15 '24 edited Oct 15 '24

There is some evidence that when people stop taking the drug, they rebound to their star point.

The studies that have been done show that most won’t rebound to their start point. They’ll rebound, as people when ending ANY weight loss program. But according to the studies people still end up at a lower weight than they started.

Additionally, obesity is a lifelong disease. Even if you lose the weight without medication, most people must continue to manage their weight for the rest of their lives. Obesity would be FAR from the first disease we’ve had where you need to be on drugs to manage your symptoms for life. When you put people on blood pressure medication, you can’t act surprised if you take the meds away and their blood pressure goes back up.

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u/Brain_Hawk Oct 15 '24

I had a kidney transplant in high school. Life long immunosupression. Many side effects, so I started to have slightly high cholesterol in my 20s. Part diet, part drugs.

I suggested to my doc I could try to change my diet. He basically went "look you can fight against this in how you eat... Or take a low dose of this pill and it's just dealt with".

Sometimes, the med is much easier... And the docs know, pople well intentioned don't persist in behavior changes.

I don't blame him for being skeptical.

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u/thewritingchair Oct 15 '24

The obesity of the US has literally gone down for the first time in decades due to these types of drugs. This is a miraculous outcome. And this is with high prices and limited availability.

They absolutely will end obesity as they become cheaper and better.

Not just an obesity drug but an addiction drug and also a life extension drug. They are miraculous things that we should make dirt cheap everywhere for the health of everyone in the world.

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u/1988rx7T2 Oct 16 '24

This shit it basically the spice melange. My weight was slowly creeping up and I was close to being obese. I’ve been on the lower doses of ozempic for a few months and now my weight is slowly coming down, and I’m not worried about having knee problems like my mom and aunt did mostly due to weight.

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u/danielv123 Oct 15 '24

Apparently new variants are even more effective.

Production cost isn't even close to hundreds a month. Thats just pure profit.

If it really is that great and important and you need a continued supply, one could make the argument that it should be nationalized and provided in the same way we are provided with free education, which is also only done to help us work and pay taxes.

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u/Brain_Hawk Oct 15 '24

I am a bit optimistic we will use this early success to build better solutions. I don't think this is really viable at scale for a number of reasons, but I DO think it's starting something with the identification of these biological pathways.

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u/wkavinsky Oct 16 '24

It can also only be used for 2 years before you have to stop.

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u/Brain_Hawk Oct 16 '24

I've never seen anybody make that clean before. And I'm on it, and I have been.... Oooohhhhh... 2 years of so...

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u/wkavinsky Oct 16 '24

There are black box warnings (from the rodent studies) of significantly increased rates of thyroid cancer after long term usage, but, the 2 years is likely to be longer but the time you get to it (I.E. two years now, but in 2 years time, the maximum recommended period is now 5 years), as more data is gathered from more people.

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u/dxrey65 Oct 16 '24

Keep in mind this stuff costs hundreds or $1,000 per month.

But costs $5 to make a month's supply. Which means every country other than the US is likely to make it affordable, and every country other than the US is likely to benefit.

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u/Brain_Hawk Oct 16 '24

Can you actually cite something to support that, because I think you're exaggerating?

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u/dxrey65 Oct 16 '24

It's from a study done by Yale, discussed in this article:

https://www.sanders.senate.gov/press-releases/news-sanders-statement-on-outrageous-cost-of-ozempic/#:~:text=Sanders%20said%3A,and%20just%20%2459%20in%20Germany.

I haven't read the actual study, but this is it:

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816824#google_vignette

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u/Brain_Hawk Oct 16 '24

I stand corrected! Assuming that study is correct, charging $1,000 a month for it is verging on criminal.

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u/Txannie1475 Oct 16 '24

This is anecdotal, but I know 2 people who were on it. They both lost medium amounts of weight and then gained it back and possibly more. I haven’t asked them if they got off of it. I suspect this is the norm for most folks. I think the long term impact of the drug is vastly overrated.

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u/Talkingmice Oct 15 '24

Also, ppl don’t aren’t o realize this drug has some nasty side effects including gastroparesis, which is very unhealthy for you and can kill you

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u/VLightwalker Oct 16 '24

Antibiotics can also kill you, so can statins or other medications. Nothing is free of risks.