Pharmacy professor discusses latest changes to weight-loss landscape

BUFFALO, N.Y. — In January, Nicole Albanese, PharmD, clinical associate professor of pharmacy practice in the University at Buffalo School of Pharmacy and Pharmaceutical Sciences, shared her knowledge of popular weight-loss drugs, such as Ozempic, Wegovy and Zepbound.

Albanese was also featured in the April episode of the University Communications podcast Driven to Discover, where she discussed how the drugs work, why they’re hugely popular, and what prevents most users from achieving long-term success.

In recent weeks, changes have occurred in the weight-loss landscape, including that the two-year long shortage of Ozempic and Wegovy has ended. This means that compounding pharmacies and other entities that have been allowed to make and distribute off-brand copies of the drugs during the shortage will have to wind down production over the next month or so.

Meanwhile, President Donald Trump has rejected a proposal made by his predecessor to expand Medicare and Medicaid coverage for obesity drugs. And, finally, the bastion of weight-loss programs, WW International, also known as WeightWatchers, is facing bankruptcy.

We sat down with Albanese to comment on the most recent news and how it relates to use of the popular weight-loss drugs going forward.

If the drug shortage has been rectified, does that mean less expensive, compounded versions will no longer exist? Advertisements for the drugs through online pharmacies continue to be aired.

This is correct. Compounding pharmacies are able to compound medications that are commercially available through a loophole in patent law that says when there is a “shortage” they can compound it. Additionally, you can compound a medication if it’s not commercially available. So, it’s possible that these drugs can continue to be compounded if they add other vitamins or minerals to it, making it different enough and not available commercially.

I’ve seen many of these semaglutide + Vitamin B12 products advertised. But Lilly, the company that makes tirzepatide (brand name Zepbound), is suing a few of these pharmacies. Soon, we will definitively know whether or not compounding pharmacies adding B12 can continue.

The New York Times recently reported that President Trump wants to reverse former President Biden’s proposal to require Medicare and Medicaid to cover weight-loss drugs as a way to treat the disease of obesity and its related conditions. The article also mentioned Secretary of Health and Human Services Robert F. Kennedy Jr.’s criticism of weight-loss drugs, saying “they’re inferior to consuming healthy food.” Do you think the decision or opinion will lead to decreased desire or use of these drugs?

I don’t think the opinions of Trump and Kennedy will decrease desire or use. Since neither Medicare nor Medicaid currently pays to treat obese or overweight patients with drugs like Saxenda or Zepbound, nothing will change. What will continue is patients who are obese and overweight trying to figure out how to get their hands on the diabetes-equivalent medications (Ozempic or Mounjaro), which then could cause shortages of those drugs in the future.

Also, many health maintenance organization (HMO) plans typically follow what the Centers for Medicare and Medicaid Services (CMS) does. So, if Medicare continues not to pay for these drugs for obese and overweight patients, other insurance plans will also continue not to pay for them. There are 100 million Americans who are obese and another 213 million who are overweight. Since these drugs are so expensive, if we made them available to everyone who might qualify, these plans could go bankrupt. It’s just not sustainable at these prices.

WW International has historically focused on food tracking and in-person meetings as a slow, steady way to lose weight. The immense popularity of weight-loss drugs was cited among the reasons for the company’s downfall. Do you see this as a trend that will continue with other traditional weight-loss programs?

I don’t know if this would be a trend, especially if access to federal programs doesn’t expand. Also, I feel like patients are not going to want to take these weight-loss drugs forever. While they may rely on them for a few years, they might eventually fall back to dieting and exercise to maintain. Then, programs such as WW will have a niche again.