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Accessibility statementSkip to main content Democracy Dies in Darkness SubscribeSign in OpinionsEditorials Columns Guest opinions Cartoons Submit a guest opinion Today's Opinions newsletter OpinionsEditorials Columns Guest opinions Cartoons Submit a guest opinion Today's Opinions newsletter OPINION HOW TO MAKE POWERFUL NEW OBESITY DRUGS AVAILABLE TO ALL By the Editorial Board |AddFollow November 26, 2023 at 7:00 a.m. EST (Washington Post staff illustration; photos by iStock) Listen 4 min Share Comment on this storyComment Add to your saved stories Save The medical sensation of the decade is a set of drugs that help people slim down. With weekly injections, people can drop 15 percent to more than 22 percent of their body weight on average, often 40, 50 pounds — or more. No safe medicine or any other weight-loss strategy except surgery has been so effective. Given that nearly 42 percent of Americans are obese, and thus vulnerable to diabetes, heart disease, stroke and various kinds of cancer, Wegovy, Zepbound and other so-called GLP-1 agonists come as a breakthrough. They offer a way to vastly improve public health — not to mention quality of life among people who struggle to lose weight. WpGet the full experience.Choose your planArrowRight Surely, health insurers, including employers and Medicare, can find a way to pay for these extraordinary drugs. If they don’t, only wealthy people will benefit — while poorer Americans are more prone to obesity. And the opportunity to bring a large share of the population back to good health will be largely lost. Doing this without drastically inflating the price of U.S. health care and straining public budgets will be hard. The monthly cost for the drugs is upward of $1,000. (Zepbound is $1,060 and Wegovy $1,350.) If Medicare’s drug-coverage program, Part D, were to cover Wegovy at the list price for all obese beneficiaries, it would cost more than the entire Part D budget — and more than the total amount of excess health-care spending on obese Americans of all ages (estimated to be $260 billion in 2016), according to an analysis in the New England Journal of Medicine. Advertisement Story continues below advertisement Skip to end of carousel ALSO ON THE EDITORIAL BOARD’S AGENDA arrow leftarrow right * Lawyers plead guilty in racketeering case in Fulton County, Ga. * The Biden administration announces more than $100 million to improve maternal health. * Wisconsin Republicans back off impeachment threat against justice. * Bahrain’s hunger strike ends, for now, after concessions to prisoners. * A Saudi court sentences a retired teacher to death based on tweets. Attorneys for Donald Trump have pleaded guilty in the racketeering case led by Fulton County, Ga., District Attorney Fani T. Willis. Even those lawyers related to the deals focused on equipment-tampering in rural Coffee County are relevant to the former president — they help to establish the “criminal enterprise” of which prosecutors hope to prove Mr. Trump was the head. The news is a sign that the courts might be the place where 2020 election lies finally crash upon the rocks of reality. The Editorial Board wrote about the wide range of the indictment in August. The Department of Health and Human Services announced more than $103 million in funding to address the maternal health crisis. The money will boost access to mental health services, help states train more maternal health providers and bolster nurse midwifery programs. These initiatives are an encouraging step toward tackling major gaps in maternal health and well-being. In August, the Editorial Board wrote about how the United States can address its maternal mortality crisis. Wisconsin state Assembly Speaker Robin Vos (R) announced Tuesday that Republicans would allow the nonpartisan Legislative Reference Bureau to draw legislative maps, a dramatic reversal after years of opposing such an approach to redistricting. A new liberal majority on the state Supreme Court is expected to throw out the current maps, which make Wisconsin the most gerrymandered state in America. Mr. Vos has been threatening to impeach Justice Janet Protasiewicz, whose election this spring flipped control of the court, in a bid to keep those maps. This led to understandable outcry. Now it seems Mr. Vos is backing off his impeachment threat and his efforts to keep the state gerrymandered. Read our editorial on the Protasiewicz election here. Prisoners are eating again in Bahrain after the government agreed to let them spend more hours outside and expanded their access to visitors, a welcome development ahead of the crown prince’s visit to Washington this week. Activists say the monthlong hunger strike will resume on Sept. 30 if these promises aren’t kept. Read our editorial calling for the compassionate release of Abdulhadi al-Khawaja, a political prisoner since 2011 who participated in the strike. A retired teacher in Saudi Arabia, Muhammad al-Ghamdi, has been sentenced to death by the country’s Specialized Criminal Court solely based on his tweets, retweets and YouTube activity, according to Human Rights Watch. The court’s verdict, July 10, was based on two accounts on X, formerly Twitter, which had only a handful of followers. The posts criticized the royal family. The sentence is the latest example of dictatorships imposing harsh sentences on people who use social media for free expression, highlighted in our February editorial. 1/6 End of carousel Part D pays for the drugs only to treat diabetes. The law bars the program from covering weight-loss medications, but Congress could easily remove this obstacle — put in place at a time when overweight status was stigmatized as a personal failing, rather than reflective of deep-seated biological drives, and weight loss was considered only a cosmetic benefit. Follow this authorEditorial Board's opinions Follow The drugs stand to be alarmingly expensive for private insurers, too. If more than a tiny fraction of the people they cover use the drugs, the cost will drive up premiums for everyone. The injections are meant to be taken in perpetuity — people who quit see much of the weight return — which could translate into an enormous addition to America’s already world-beating health-care costs. Yet more and more employers are covering them, as most Americans want them to do. Limiting demand would be a daunting challenge because almost half the U.S. population meets the Food and Drug Administration criteria for taking them: They have either a body mass index of at least 30 (obesity) or a BMI of 27 (overweight) and at least one weight-related ailment (diabetes, high blood pressure or high cholesterol, for example). Not everyone who qualifies will want the drugs, of course, and many who start taking them will quit. A recent study found that 68 percent of patients stop within a year of starting — presumably, this is at least in part because of unpleasant gastrointestinal side effects. But demand is already so high, the drugmakers are having trouble keeping up. Advertisement Story continues below advertisement This demand also keeps prices aloft. The medicines are priced at least 40 percent higher than what would be cost-effective, considering their benefits, according to the Institute for Clinical and Economic Review, a research organization. But the list prices aren’t immutable; they’re subject to negotiation. Private insurers strike deals with drugmakers to pay significantly less. And prices will fall as similar new drugs hit the market — and, in years ahead, as generic versions of the drugs emerge. Note that Zepbound, which the FDA approved for weight loss this month, is cheaper than Wegovy, approved in 2021, even though studies suggest Zepbound may work a bit better. Insurers can lower their prices by buying the medicines in bulk, guaranteeing drugmakers large markets. This strategy could also work for state Medicaid programs, only a limited number of which now pay for the drugs. For Medicare specifically, Congress needs to grant Part D the authority to not only cover the medicines but also include them among the medicines for which the program can negotiate prices. Advertisement Story continues below advertisement Even as prices fall, the federal government has a responsibility to support broader studies of the drugs’ long-term safety. It must also keep up other efforts to address obesity — including by discouraging ultra-processed food and by encouraging greater physical activity (for example, by improving school lunches, food package labeling, and public spaces and pathways for exercise). The weight-loss drugs are not miracle cures. Many people cannot or do not want to tolerate them, and even patients who shed many pounds often remain obese or overweight. The medicines are one weapon in the obesity fight — but one that, if broadly used, may be powerful enough to make a big difference. THE POST’S VIEW | ABOUT THE EDITORIAL BOARD Editorials represent the views of The Post as an institution, as determined through discussion among members of the Editorial Board, based in the Opinions section and separate from the newsroom. Members of the Editorial Board: Opinion Editor David Shipley, Deputy Opinion Editor Charles Lane and Deputy Opinion Editor Stephen Stromberg, as well as writers Mary Duenwald, Christine Emba, Shadi Hamid, David E. Hoffman, James Hohmann, Heather Long, Mili Mitra, Eduardo Porter, Keith B. Richburg and Molly Roberts. Share 1502 Comments Popular opinions articles HAND CURATED * Opinion|It should be the end of the trail for the Jeep Cherokee November 30, 2023 Opinion|It should be the end of the trail for the Jeep Cherokee November 30, 2023 * Opinion|Ukraine aid’s best-kept secret: Most of the money stays in the U.S.A. November 29, 2023 Opinion|Ukraine aid’s best-kept secret: Most of the money stays in the U.S.A. November 29, 2023 * Opinion|In Russia, the shift in public opinion is unmistakable November 28, 2023 Opinion|In Russia, the shift in public opinion is unmistakable November 28, 2023 View 3 more stories More from the Editorial Board * Opinion|Sandra Day O’Connor is gone. 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