2. September 2024
Marius Müller Westernhagen sang: “I’m glad I’m not fat, because being fat is torture.” Does Marius’ song just reflect a way of life? Or is it even medically indicated? That is what a looming political dispute is about between the Union on the one hand and the health authorities headed by SPD minister Karl Lauterbach on the other. An entire industry is following the outcome of the dispute with great interest, including dozens of German start-ups for which – depending on the case – a golden or a mixed future is in sight. And if you want, you can watch YouTube videos from the 1980s or 1990s that show Germans in pedestrian zones. There are hardly any extreme heavyweights there. What happened?
Do we pay for it or not?
And what is the argument about? It is simply about whether being fat is an illness and the corresponding treatment – losing weight – is covered by health insurance. Or not. In other countries, such as the Netherlands, this is the case. In Germany, where the Robert Koch Institute estimates that at least one fifth of adults carry so much fat that it deserves the medical term obesity, the treatment is dismissed by the responsible body, the Federal Joint Committee (G-BA), as a “lifestyle” decision. So far, it is not a case for health insurance.
The topic has gained enormous momentum since weight-loss injections such as Wegovy or Mounjaro took over the market, taking the pounds off those affected and making the manufacturers a fortune. Patients inject the stuff under the skin once a week using a prefilled pen that resembles a pen. The active ingredient in Wegovy, semaglutide, has long been used to treat type 2 diabetes – under the trade name Ozempic. Wegovy contains the same active ingredient in higher doses and has been approved for people with obesity. Anyone with a body mass index (BMI) of at least 30 is considered obese. Even if that is no longer considered the gold standard, that is pretty crazy. Manufacturer Novo Nordisk has been in stock market heaven since its launch. Mounjaro contains the active ingredient tirzepatide. It works in a similar way and comes from pharmaceutical giant Eli Lilly, which used it to increase its share price by more than 50 percent in the past twelve months.
There is also something wrong with the prices. If you look at the USA, a study by “Economic Perspectives” on pricing there states that Ozempic costs 936 US dollars per month. But the implicit net price received from the manufacturer is only 290 USD. Mounjaro even charges 1,023 US dollars per month, but the net price is a mere 215 USD. And it gets even worse: A study by researchers at Yale University, London’s King’s College Hospital and Doctors Without Borders estimates that a month’s supply of Ozempic for one treatment could be produced for an estimated 89 cents to 4.73 dollars. Here, someone is making more than a fortune with the “new” miracle drugs.
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