Obesity is a major global health crisis, especially in the United States, but newer weight-loss drugs like Eli Lilly’s (LLY-0.24% ) Zepbound could offer a long-awaited solution — if they become more accessible.
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Worldwide, obesity rates among adults have more than doubled since 1990, with over 1 billion people — one in eight globally — classified as obese in 2022, according to the World Health Organization. In the U.S., the numbers are even starker with 40% of American adults being considered obese.
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It’s no wonder then that a newer class of highly-effective weight-loss drugs, known commonly as GLP-1 or incretin treatments have taken the country by storm.
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Analysts at Morgan Stanley (MS-0.02% ) project that the global market for these weight-loss drugs could reach $105 billion by 2030. In the U.S. alone, adoption is expected to grow to 31.5 million people — approximately 9% of the population — by 2035.
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The growing use of these drugs could be a “game changer” for long-term healthcare outcomes and costs, president of Lilly Cardiometabolic Health Patrik Jonsson told Quartz in an interview. However, due to their high-price and lack of widespread insurance coverage, these medications remain inaccessible to many patients.
“Obesity is a chronic disease with more than 200 downstream indications,” Jonsson said. “I can’t think of any other chronic disease that is not covered in insurance plans outside of obesity.”
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Jonsson began leading the company’s most lucrative division this January. He now oversees Eli Lilly’s pipeline of incretin medications, including its blockbuster weight-loss drug Zepbound.
Zepbound belongs to the incretin class medications, which was made popular by Ozempic, Novo Nordisk’s diabetes treatment. These drugs mimic hormones that reduce appetite and regulate blood sugar. Demand for these medications have transformed Novo Nordisk (NVO+0.34% ) and Eli Lilly into the largest pharma companies in the world.
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Now, recent studies and clinical trials have found that these drugs also have health benefits beyond weight loss, potentially paving the way for broader insurance coverage and thus wider-access.
Earlier this year, Eli Lilly published results of a study that found that the drug behind Zepbound was found to help nearly eliminate the risk of diabetes for adults who are pre-diabetic and are overweight or obese.
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The drug was tested on over 1,000 adults over the course of three years who had pre-diabetes and were overweight or obese.
Patients who took weekly doses of tirzepatide, the active ingredient in Zepbound, reduced their risk of developing type 2 diabetes by 94%, compared to patients who were on a placebo.
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“What does it mean if we prevent diabetes or at a minimum delay the onset of action with three, five, ten years? The impact on humanity is significant,” Jonsson said of the potential implications of the study.
Additionally, the company announced results of trials that showed the drug could help with other conditions like heart failure.
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Its competitor Novo Nordisk has also explored additional medical uses for its incretin medications, such as treating chronic kidney disease.
Jonsson said this growing bank of evidence “underscores the value of treating obesity.”
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This year, the U.S. Food and Drug Administration approved Novo Nordisk’s weight-loss drug Wegovy for reducing the risk of serious cardiovascular events, such as heart attacks and strokes. As a result, Medicare began covering the drug. Medicare is currently only allowed to cover these medications for weight loss if they are prescribed to treat a second condition as well.
And in December, the FDA approved Zepbound as the first prescription drug to help alleviate moderate-to-severe obstructive sleep apnea (OSA) for adults with obesity, opening the door for Medicare to cover the drug.
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President Joe Biden is now trying to expand access to pricey blockbuster drugs in his final months in office. The Biden-Harris administration proposed a new rule on in November that would expand coverage of the anti-obesity medications for Medicare and Medicaid beneficiaries.
The proposal must still undergo the formal rule-making process, which could take several months, and would require endorsement from President-elect Donald Trump to be implemented.
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This complicates the issue since Trump has named Robert F. Kennedy Jr., as his choice to lead the U.S. Department of Health and Human Services, which oversees the Center for Medicare and Medicaid Services (CMS).
Kennedy has previously come out more strongly against the growing use of these drugs. Instead, he has repeatedly promoted healthy eating as a solution to the country’s obesity epidemic.
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Jonsson rejected the notion that diet and exercise alone could solve the obesity crisis.
“In all the clinical trials, not just for Lilly, but I think for most of our competitors as well, there is a placebo arm that includes diet and exercise,” Jonsson said. “So, diet and exercise are regularly checked in placebo-controlled trials. And it’s not sufficient. It’s never even close to making a significant difference.”