In the world of weight loss products, three names have been making waves: Ozempic, Wegovy, and Mounjaro. These medications have garnered attention for their potential to aid in weight loss, but each comes with its own costs. In this post, we will explore the key details of each product and delve into the recent developments in the industry surrounding them. Additionally, we will provide a brief timeline of important milestones and dates, shedding light on the progress made in this dynamic field. First, let’s review the key details of each product: Ozempic (semaglutide)

• Manufacturer: Novo Nordisk
• Class: glucagon-like peptide (GLP-1) receptor agonist
• Formulation: injection for subcutaneous administration

Approved Indication: adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (1)

Without insurance, Ozempic costs around $892.06 per month. Novo Nordisk offers an Ozempic savings card for up to a 90 day supply of Ozempic. To qualify patients can save up to $150 off a 1 month prescription, $300 off a 2 month prescription, or $450 off a 3 month prescription. Novo Nordisk also offers a patient assistance program that provides Ozempic at no cost. Most prescription drug plans cover Ozempic when prescribed for certain diagnoses. (2) The FDA first approved Ozempic for diabetes in 2017. In 2021, the FDA then approved a drug with a higher dose of the active ingredient in Ozempic, called Semaglutide, to treat obesity, under the brand name Wegovy. Wegovy (semaglutide)

• Manufacturer: Novo Nordisk
• Class: glucagon-like peptide (GLP-1) receptor agonist
• Formulation: injection for subcutaneous administration

Approved Indication: adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adult patients with an initial BMI of 30 kg/m2 or greater (obesity) or 2 kg/m2 or greater (overweight) in the presence of at least one weight-related condition such as hypertension, type 2 diabetes mellitus, or dyslipidemia (3) A package of Wegovy contains 4 pens, each pre-filled with a single dose of Wegovy, which is about a month’s worth of treatment. Without insurance, the list price of Wegovy is about $1,349.02 per package, which is $269.80 per week or $16,188.24 per year. Patients who don’t have insurance are able to save on Wegovy and lower the price they pay through prescription discounts from GoodRx which would allow patients to save 7%-35% on the retailer’s price. Novo Nordisk does offer a savings program for patients looking to lower their costs. Through the WeGoTogether program, patients can pay as little as $0 for a 28 day supply of Wegovy if they have private or commercial insurance with prescription drug coverage. Patients whose insurance doesn’t cover Wegovy, can save up to $500 for a 28 day supply with the savings offer. Generally, Medicare prescription drugs don’t cover weight loss drugs or other medications that treat obesity. Being said, Wegovy is not covered by Medicare prescription drug plans. (4)

Mounjaro (Tirzepatide)

• Manufacturer: Eli Lilly and Company
• Class: glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist
• Formulation: injection for subcutaneous administration

Approved Indication: adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (5) The list price of Mounjaro is $1,023.04. That breaks down to $255.76 per week, or $13,299.52 per year. Each package contains 4 pre-filled pens which is a 28 day supply. The price for patients can range from $1,071 to $1,351 without coupons or insurance. How much a patient pays for Mounjaro would depend on their insurance coverage and the pharmacy they pick up their prescription. Eli Lilly provides a Mounjaro Savings Card with limits the cost of Mounjaro to $150 per month and $1,800 per year, which an 85% saving. With the savings car, patients can pay as little as $25 for a 1 month or 3 month supply of Mounjaro. To use the Mounjaro savings card, patients must be a resident of the United States or Puerto Rico, with a Mounjaro prescription for type 2 diabetes, and no prescription drug coverage through federal or state-funded insurance. The savings card is available to patients with commercial health insurance. Mounjaro is not covered by Medicare prescription drug plans. (6) Since 2022, Ozempic has been in the forefront of news among health care providers, patients, and the world of pharmacy.

Celebrities and social media influencers have come out saying that they would use Ozempic for weight loss in short time frames. The FDA first approved Ozempic for diabetes in 2017. In 2021, the FDA then approved a drug with a higher dose of the active ingredient (semaglutide) in Ozempic to treat obesity, under the brand name Wegovy. Mounjaro, which is a diabetes medication, has also gained popularity for its weight loss effects. It's normal for doctors to prescribe medications for “off-label” use, or a different purpose from what the medication is approved for. Interest in Ozempic has increased drastically, and prescribers believe that more and more people are looking to take the drug for weight loss. Healthcare providers are worried that people would just view Ozempic as a regular drug that is meant for weight loss when in reality, it is a critical medication for diabetic patients. Because semaglutide imitates glucagon-like peptide-1 (GLP-1), it limits appetite by signaling to the body that you feel full and promotes the stomach to empty more slowly. Ozempic hasn’t been significantly studied in people without diabetes or excess weight and hasn’t been approved by the FDA for weight loss. However, after the FDA authorized Wegovy for weight loss, there was such demand for the drug that providers turned to prescribing Ozempic when they couldn’t get Wegovy.

The rise in individuals using Ozempic for weight loss has been contributing to the shortage of Ozempic and patients with diabetes and obesity are struggling to access the product. Patients who use Ozempic and Wegovy for weight loss will need to keep taking them long-term in order to keep the weight off. Patients who stop taking Ozempic or Wegovy often gain their weight back relatively quickly. (7) Many patients have started turning to compounding pharmacies to get cheaper doses of semaglutide, and the FDA says that it has received many reports of adverse events after people took these doses. The FDA mentions that patients should not use a compounded drug if an approved drug is available, and that the FDA doesn’t review compounded versions of these drugs for safety, effectiveness, or quality. (8) Novo Nordisk’s semaglutide is set to enter two phase III metabolic disorder clinical trials for both injection and oral formulations as treatments for postpartum glucose intolerance and weight loss. Trials are being executed to investigate Ozempic’s use as treatment for glucose intolerance in women with prior gestational diabetes mellitus (GDM).

Novo Nordisk is also investigating a daily oral version of Semaglutide in adults with body weight above the healthy range. (9) With Ozempic and Wegovy’s popular rise as weight loss drugs, Eli Lilly’s Mounjaro has shown even higher levels of weight loss as patients have reported to lose about 21% of their body weight in clinical trials. Eli Lilly is working on clinical trials to seek approval from the FDA to approve Mounjaro for chronic weight management in people who have obesity or are overweight with weight related conditions. New clinical trials and results would allow Eli Lilly to complete its submission to the FDA for a potential approval by the end of the year. (10) Timeline Important milestones in the news surrounding Ozempic, Wegovy, and Mounjaro

• December 5, 2017: Ozempic (semaglutide) received approval from the U.S. Food and Drug Administration (FDA) for the treatment of type 2 diabetes.
• June 4, 2020: Novo Nordisk announces positive results from a clinical trial evaluating Wegovy (semaglutide) as a weight loss treatment in individuals with obesity.
• June 4, 2021: The FDA approves Wegovy (Semaglutide) as a once-weekly injection for chronic weight management in adults with obesity.
• November 11, 2021: The European Medicines Agency (EMA) recommends the approval of Wegovy (semaglutide) for the treatment of obesity in adults.
• September 2021: The EMA approves Novo Nordisk’s Wegovy, making it the first once-weekly treatment for obesity available in Europe.
• February 16, 2022: Novo Nordisk announces that Wegovy has been shown to reduce cardiovascular events in overweight or obese individuals with cardiovascular disease, based on the STEP 4 trial results.
• May 13, 2022: Eli Lilly’s Mounjaro is approved by the FDA for blood sugar control in adults with type 2 diabetes as an addition to diet and exercise.
• May 17, 2022: Novo Nordisk announces positive results from the STEP 2 trial, indicating the effectiveness of Wegovy in adolescents aged 12-17 years with obesity.
• April 27, 2023: Eli Lilly released new data to support its aim of fast-track approval, including results from SURMOUNT-2 , which shows weight loss of up to 15.7% among people with Type 2 diabetes and obesity.
• June 3, 2023: Clinical trials investigating the use of Mounjaro in combination with lifestyle modifications show promising results, leading to speculation about potential approval for expanded indications in the future. Kiana Dixson PharmD, BCMAS Andy Cheung PharmDc References

1. CenterWatch RSS. (n.d.-b). Ozempic (semaglutide) subcutaneous injection. CenterWatch RSS. https://www.centerwatch.com/directories/1067-fda-approved-drugs/listing/3985-ozempic-semaglutide-subcutaneous-injection
2. Willson, A. (2023, March 13). How much does Ozempic cost without insurance? . Ro. https://ro.co/weight-loss/ozempic-cost-without-insurance/
3. CenterWatch RSS. (n.d.). Wegovy (SEMAGLUTIDE) injection. CenterWatch RSS. https://www.centerwatch.com/directories/1067-fda-approved-drugs/listing/4714-wegovy-semaglutide-injection#:~:text=Mechanism%20of%20Action&text=Semaglutide%20acts%20as%20a%20GLP,brain%20involved%20in%20appetite%20regulation
4. Willson, A. (2023, February 24). How much does Wegovy Cost?. Ro. https://ro.co/weight-loss/wegovy-cost/
5. CenterWatch RSS. (n.d.-a). Mounjaro (tirzepatide). CenterWatch RSS. https://www.centerwatch.com/directories/1067-fda-approved-drugs/listing/4792-mounjaro-tirzepatide#:~:text=Mechanism%20of%20Action,and%20prolongs%20the%20half%2Dlife
6. Willson, A. (2023, April 13). Mounjaro Cost: How to save money on Mounjaro. Ro. https://ro.co/weight-loss/mounjaro-cost-insurance-coupons/
7. Blum, D. (2022, November 22). What is Ozempic and why is it getting so much attention?. The New York Times. https://www.nytimes.com/2022/11/22/well/ozempic-diabetes-weight-loss.html
8. Kindelan, K., & Wetsman, N. (2023, June 1). FDA warns about safety of “off-brand” versions of Ozempic, Wegovy. ABC News. https://abcnews.go.com/GMA/Wellness/fda-warns-safety-off-brand-versions-ozempic-wegovy/story?id=99763818
9. Fultinavičiūtė, U. (2022, October 21). Just announced: Upcoming late-stage clinical trials in weight loss and diabetes. Clinical Trials Arena.https://www.clinicaltrialsarena.com/news/industry-news/metabolic-disorder-clinical-trials
10. Aubrey, A. (2023, April 27). Eli Lilly releases more data for new obesity drug, moving toward fast-track approval. NPR. https://www.npr.org/sections/health-shots/2023/04/27/1172365791/eli-lilly-releases-more-data-for-new-obesity-drug-moving-toward-fast-track-appro /