By Ted Kyle, RPh, MBA, originally published on ConscienHealth.org.
Reporters are writing a lot about the unaffordable cost of new obesity medicines like semaglutide. They’re doing a lot of really solid reporting. But unfortunately, they are also pushing out a false narrative and just about everyone else is coming along for the ride. Time and time again we see journalists reporting inflated costs for obesity meds – leaning on list prices that almost no one actually pays. For example, Anna Wilde Mathews and Ray Smith reported recently in the Wall Street Journal that employers “are wary of footing the bill for medicines that list for $900 or more a month.”
But for health insurance that covers these drugs, those list prices are a fiction. In fact, the net price after drug rebates is half of that or less. Because of the secretive behaviors of PBMs, though, there’s absolutely no transparency about net prices.
A Doubly Raw Deal for Patients
These bogus list prices are a double whammy for patients. CEO Joe Nadglowski of the Obesity Action Coalition explains:
“Reporting like this serves to justify insurance companies limiting coverage by emphasizing the expensive list prices for these important medicines. In reality, no insurance company is paying those numbers after rebates. With rebates reported to be 50%, the only people who pay those amounts are consumers paying out of pocket.
“The gap between list and net prices is thus a problem for two reasons. It gives insurance and employers an excuse for denying access to these potentially life-changing medicines. And it also leaves patients who have big copays based on list price with a hefty bill to pay – one that does not reflect the real cost of these drugs.”
Obscuring the Truth
So by reporting these inflated list prices as if they represent the true costs of obesity meds, otherwise excellent journalists are serving to obscure the truth. At some point, they will wake up and think more critically, digging deeper on real drug costs. The public will benefit when they do.
Click here, here, and here for examples of stories that quote inflated costs for obesity medicines. For perspective on how rebates and PBMs contribute to this confusion, click here and here. Finally for perspective on the cost of anti-obesity medicines, click here.
OAC believes that obesity is a complex, chronic disease that requires serious action, access to science-based treatment and comprehensive obesity care to improve quality of life and health. We demand that people affected by obesity have access to affordable medical coverage in the same way as those with other chronic diseases. People with obesity should be treated with the same dignity and respect offered to their peers, and we need your help in this fight.
Here’s how you can make a difference: