pharma
The gigantic business of the new obesity drugs
Maria Fabrizio for STAT
A new generation of highly effective obesity medications, and the overt and subtle messaging from the pharmaceutical companies making them, is changing the narrative around obesity, my colleagues Elaine Chen and Matt Herper report in a new, deeply reported story.
This represents one of the biggest financial opportunities ever for drugmakers. These medicines — called incretin mimetics or GLP-1 drugs — are already used to treat diabetes, generating $23 billion in annual sales. But using the same drugs to also treat obesity could result in a $100 billion market in less than a decade.
That amount of money swirling around naturally is creating some questionable behaviors. Elaine and Matt learned Novo Nordisk, which makes one of these drugs called Wegovy, funded the development of coursework on obesity for medical schools, which shocked several experts.
This is the first article in a series about these medications. Read their initial opus, which covers the history of weight loss drugs and how the industry and doctors are framing the issue. And stay tuned for more.
insurance
Well, that was a quick change of heart
Imagine your health insurer previously covered a drug at 100%, a drug your doctors say helped to send your deadly illness into remission for almost a decade. Now, imagine the disease comes back, and the same insurer denies coverage for the same drug. Three times.
This is the epitome of when prior authorization comes off as cold and arbitrary. Health Care Inc. co-pilot Tara Bannow interviewed a 46-year-old mom of three who was struggling to get her health insurer, Blue Cross Blue Shield of Massachusetts, to cover an infusion drug called Rituxan for her rare kidney disease. Two days after Tara asked BCBS of MA what was up, the company said it decided to cover the biosimilar version of the drug after all.
It’s a positive outcome for this patient, but there are undoubtedly countless patients out there wondering why they can’t get their previously covered drugs. In this case, BCBS of MA said it didn’t require prior authorization for Rituxan back in 2014, but it has since beefed up its guardrails around the pricey drug. Read more.
hospitals
When a small hospital merger raises big antitrust questions
Cross-market hospital mergers are all the rage for potentially avoiding antitrust heat. A proposed combination of Presbyterian Healthcare Services and UnityPoint Health is the latest one, Tara reported last week.
But don’t sleep on the ho-hum, smaller-potato announcements of local hospitals that switch owners — especially if the new owners already gobble up a lot of the market. Case in point: Novant Health is buying two hospitals and related clinics north of Charlotte for $320 million, which will give Novant significantly more market power. Some public figures are already voicing opposition.
“If the same thing happens with [this deal] as it did with the last Novant acquisition, the quality of care is going to go down, and the cost of care is going to go up,” Dale Folwell, North Carolina’s treasurer, told me. “This is like an onion: The more you peel, the more you cry. These hospitals … at every turn, it’s profits over patients.”
Read more about this deal in North Carolina, how prices and employee wages could be affected, and what the area’s only other acute-care hospital thinks about it.
