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Six reasons why it’s so hard to get your weight loss medication

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About 3.8 million people in the United States — four times as many as two years ago — now take the most popular weight-loss drugs, according to the IQVIA Institute for Human Data Science, an industry data provider.

Some of these prescriptions relate to diabetes. The drugs are Novo Nordisk’s Ozempic and Wegovy (the same drug sold under different brand names), and Eli Lilly’s Mounjaro and Zepbound (also the same drug).

Pent-up demand is even higher because many people who want these drugs can’t find them or can’t afford them. Without insurance coverage, people have to pay out of pocket. If they get a coupon offering a discount from Eli Lilly, people with commercial insurance pay $550 per month for Zepbound. For those who are commercially insured, a Novo Nordisk coupon for Wegovy reduces the pharmacy bill by $500, or a cost of about $1,000 per month.

And interest is expected to continue to grow.

Novo Nordisk and Eli Lilly tried to respond by increasing production, but they failed to produce enough to meet demand.

Only a limited number of plants in the world are ready and available to make injectable drugs, which are more difficult to make than pills. To add to the complexity, each company manufactures at least five strengths of its drug.

“These are complex sites, very technically demanding, capital-intensive work, populated with highly specialized machines and often manufactured in small companies,” David Ricks, chief executive of Eli Lilly, said last month.

For Eli Lilly, which sells Zepbound for weight loss, a crucial bottleneck has been producing enough of the pens used to inject the drug.

Novo Nordisk, Wegovy’s maker, has had an even harder time than Eli Lilly producing enough of its drug, even as it tries to catch up. He said that in January he more than doubled the supply of doses for new patients, estimating the drug would reach pharmacies within weeks.

This situation is unusual, said Erin Fox, an expert at the University of Utah who tracks drug shortages. Most shortages involve older drugs for which there is little financial incentive to manufacture them. “Usually, if there is a very profitable drug, we don’t see a shortage,” she said.

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