Opinion | The Miracle Weight-Loss Drug Is Also a Major Budgetary Threat

The U.S. health care system has struggled for decades with the tension between providing incentives for pharmaceutical innovation and keeping breakthroughs affordable for those who would most benefit from them. Even as countries around the world have stepped in to require lower priced drugs for their citizens, the United States has been reticent to do so. As a result, U.S. consumers pay the highest prices in the world for drugs, by a wide margin.

But the impetus for more fundamental reform may come from an unexpected place: America’s obesity epidemic. Many of us are aware that there is a new class of weight-loss drugs that offer enormous promise in addressing obesity. But there is far less awareness of the fact that these drugs also introduce an enormous risk to America’s taxpayers.

The magnitude of potential benefit and potential cost — roughly $15,000 per year per person — posed by these drugs suggests that policymakers may have no alternative but to step in and bring their costs in line with their social benefits. If policymakers succeed in doing so, we could build a model for drug price negotiation that enables an extraordinary medical breakthrough to improve both our health and our fiscal position. Or we could do nothing and create one of the biggest fiscal problems of the decade, with pharma companies profiting at the expense of the taxpayer and of equitable health outcomes.

Produced by the Danish pharmaceutical company Novo Nordisk, Ozempic and Wegovy are part of a new class of “GLP-1 receptor agonists” that regulate dopamine and help the body process sugar more effectively. Recent studies have shown that the drugs are effective at both reducing weight and preventing diabetes, and their U.S. sales reached more than $13 billion in 2023.

These drugs have the potential to significantly reduce the expenses for obesity-related illnesses and for the condition itself, the cost of which is about $210 billion annually and growing. More than 40 percent of Americans are already classified as obese, and that share is projected to reach nearly 50 percent by 2030. In 2021, already 38 percent of Americans were estimated to be prediabetic, and in that same year, another 12 percent were diagnosed as diabetics. We desperately need game-changing weight-loss innovations.

Unfortunately, these drugs are also very expensive, and current evidence suggests that users need to continue to take the drug indefinitely to keep the weight off.