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New research suggests that anti-obesity drugs could be developed and sold globally for much less than their current high costs. The study calls for a public health approach to obesity control, prioritizing drug availability over pharmaceutical company profits.

Price changes can improve affordability and access to treatment.

A number of anti-obesity drugs can be manufactured and sold profitably at low prices globally, despite their high costs, new research suggests. Excessive obesityflagship journal of the Obesity Society (TOS).

“Access to medicine is a fundamental part of the human right to health. As the obesity epidemic continues to grow, particularly among low-income communities, effective treatments are out of reach for millions of people. Our study highlights the cost inequity of effective anti-obesity drugs, which are largely unaffordable in most countries. However, we show that these drugs can be manufactured properly and sold at a low price. A public health approach needs to be taken that prioritizes improving access to medicines rather than allowing companies to maximize profits,” said Jacob Levy, Integrative Care Medicine, Royal Free Hospital NHS Trust, London, UK. Levi is the corresponding author of the study.

Growing recognition that diet and exercise alone cannot lead to sustained weight loss has led to a renewed demand for medications to complement lifestyle changes, experts say. Randomized controlled trials have shown positive results with oral and injectable medications. However, these drugs are very expensive in most countries. Such high prices make it a challenge for millions of people to afford the drug and access treatment.

“It would be ideal if everyone had affordable access to all the drugs that could improve their health. But that is simply not possible, and it will never be. What is needed is a better way to allocate current health care dollars in an effort to improve public health. This is the challenge ahead for anti- “It’s not just about obesity medicine, it’s about all treatments,” Eric Finkelstein, a professor at Duke NS Medical School in Singapore, commented on the study.

On the other hand, the authors call for a public health-based approach to obesity management similar to other diseases. The study’s lead author, Andrew Hill, Department of Pharmacology and Therapeutics, University of Liverpool, UK, commented: “Globally, diabetes and clinical obesity account for more deaths than HIV, tuberculosis and malaria. He was able to save millions of lives by treating infectious diseases at low cost in poor countries. Now we need to repeat this medical success story, treating diabetes in bulk and clinical obesity at low cost. Pharmaceutical companies have an ethical responsibility to make their new diabetes and obesity treatments available to anyone in any country who needs them.

The study’s authors searched national drug price databases and collected data on six drugs: orlistat, naltrexone/bupropion, topiramate/phentermine, liraglutide, semaglutide, and tirzepatide in 16 low-, middle-, and high-income countries. In each country, researchers reviewed several online national price databases and selected the lowest price from each source. Medicines are chosen because their effectiveness is proven and they show different monotherapies, combined tablets and injectable treatments.

Estimated minimum costs (EMPs) for anti-obesity drugs were calculated using an established method using active pharmaceutical ingredients from the Panjiva database. EMPs are calculated over a 30-day course and include the costs of active pharmaceutical ingredients, excipients, formulary, taxes and 10% profit margin.

The results show that if the cost of oral and injectable anti-obesity drugs is calculated, E.M.P.

oral medications;

  • Orlistat: The cost of a 30-day treatment was over $100 in the US and less than $1 in Vietnam. The EMP from exports was approximately $7 per 30-day course.
  • Naltrexone/bupropion: The price of naltrexone/bupropion combination tablets ranges from $326 in the United States to $56 in South Africa, with a 30-day course costing $55.
  • Topiramate/phentermine: Price information is only available in the United States because the drug is not licensed for weight loss use in many countries due to safety concerns. U.S. prices ranged from $120 to $199 per course, compared to $5 for EMP combination tablets. Prices for topiramate and phentermine were calculated separately and combined with data from the United States, South Africa, and Kenya. Based on API export data, the EMP for each drug was $0.86 for topiramate and $0.53 for phentermine ($1.39 per course overall).

Injectable drugs:

  • Liraglutide The injectable antidiabetic and weight loss agent liraglutide costs $1,418 in the United States and $252 in Norway. A 30-day course of EMP was $50. Researchers noted that this price was calculated taking into account the most efficient concentration and the number of pens available for injection.
  • Semaglutide National price data for subcutaneous semaglutide were all higher than EMPs, ranging from $804 in the United States to $95 in Turkey. A subcutaneous semaglutide EMP is calculated to be approximately $40 per 30-day course.
  • Tirezapatide: National price data are available only in the United States, where the drug was recently approved by the Food and Drug Administration for use in type 2 diabetes. The drug is not licensed for obesity alone. Prices for a 30-day course ranged from $715.56 to $1,100.70. There is insufficient data in the database to calculate the EMP.

The authors of the study note that EMPs are intended as realistic targets for competitive generic production rather than patented versions.

Caroline M. Apovian, MD, FTOS, is associate director of the Center for Weight Management and Health at Harvard Medical School in Boston, Mass. , Professor of Medicine, “Once the combination of anti-obesity agents, especially GLP-1, and lower cardiovascular risk, we can demand universal insurance coverage of these agents.” These agents are used for obesity before type 2 diabetes develops.[{” attribute=””>cardiovascular disease and other complications, have the power to reduce the cardiovascular burden and lower mortality worldwide.” Apovian was not associated with the research.

The study, titled “Estimated Minimum Prices and Lowest Available National Prices for Anti-obesity Medications: Improving Affordability and Access to Treatment,” is online and was published in the May 2023 print issue of Obesity.

Reference: “Estimated minimum prices and lowest available national prices for antiobesity medications: Improving affordability and access to treatment” by Jacob Levi, Junzheng Wang, Francois Venter and Andrew Hill, 23 February 2023, Obesity.
DOI: 10.1002/oby.23725

Other authors of the study include Junzheng Wang, Medical Sciences Office, Oxford University, Clinical Academic Graduate School, University of Oxford, Oxford, United Kingdom and Francois Venter, Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Venter has received support from the Bill and Melinda Gates Foundation, U.S. Agency for International Development, Uni-taid, SA Medical Research Council, Foundation for Innovative New Diagnostics, the Children’s Investment Fund Foundation, Gilead, ViiV, Mylan, Merck, Adcock-Ingram, Aspen, Abbott, Roche, Johnson & Johnson, Sanofi, Virology Education, SA HIV Clinicians Society and Dira Sengwe. The other authors declared no conflict of interest.

Funding for this study was provided by the Make Medicines Affordable/International Treatment Preparedness Coalition, grant number ITPC-MV_2020, and National Heart, Lung, and Blood Institute of the National Institutes of Health under award number UG3HL156388.

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