What is EL’s endgame here?

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Peachyp6369

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www.onthepen.com

OTP Exclusive: Lilly Has Been Quietly Exploring Alternative Avenues to Shut Down Tirzepatide Compounding

In an exclusive interview last night with Scott Brunner, CEO of the Alliance for Pharmacy Compounding, we uncovered a bombshell: Eli Lilly has been working quietly but diligently on additional means to remove compounded versions of tirzepatide—the active ingredient in Mounjaro and Zepbound—from...
www.onthepen.com www.onthepen.com

They’ve been trying to say it’s a demonstrably difficult compound since August. But it’s obvious no one can afford it and by next year better drugs will be available so it’s almost like they don’t want people on it? What a truly weird way to drive people away. They could make it affordable and make so much more money. This drug costs $84 in Japan so it’s not like it’s costly to manufacture. Am I missing something here? Do they really think people will pay $1000 a month for it?
 
Peachyp6369 said:
www.onthepen.com

OTP Exclusive: Lilly Has Been Quietly Exploring Alternative Avenues to Shut Down Tirzepatide Compounding

In an exclusive interview last night with Scott Brunner, CEO of the Alliance for Pharmacy Compounding, we uncovered a bombshell: Eli Lilly has been working quietly but diligently on additional means to remove compounded versions of tirzepatide—the active ingredient in Mounjaro and Zepbound—from...
www.onthepen.com www.onthepen.com

They’ve been trying to say it’s a demonstrably difficult compound since August. But it’s obvious no one can afford it and by next year better drugs will be available so it’s almost like they don’t want people on it? What a truly weird way to drive people away. They could make it affordable and make so much more money. This drug costs $84 in Japan so it’s not like it’s costly to manufacture. Am I missing something here? Do they really think people will pay $1000 a month for it?
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Yes, they do think that. yes, people will if they have to, or at least enough. Why is this so difficult to understand? They are wanting to get the most they can get, not save lives. Why is a pharmaceutical different than a car? Truly, we need to stop thinking healthcare and get with the viz.😔
 
They want 1k per month whether you’re on tirz or Reta or any other drug really. Their end game is they make the drug as inaccessible as possible via alternative means. They’re banking on enough insurances coming on board that 1k a month (or some other negotiated value) would still net way more than Japan’s price
 
rkl123 said:
They’re banking on enough insurances coming on board that 1k a month (or some other negotiated value) would still net way more than Japan’s price
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This.

They are actively working with the PBM's and insurers to get it covered but patient copays could be higher than compound Tirz. If the cost is similar and a patient is on compound there is no incentive to switch and deal with insurance, constant doctor follow-up visits, hunting down your next dose when you can't refill before you're due for your next shot,

It is a serious PITA. My insurance covers it but I choose compound and have a stock of gray in the freezer. I throw the pens in the fridge for the future.

My 28 day script period was up on Monday but CVS wouldn't fill without my Dr submitting a prior authorization form. Jumped that hurdle and then CVS was out of stock. They send it to another CVS several towns over, then they ran out of stock. Finally got my 7.5 Zep on Thursday which would have been three days past my shot day. I hear the wait for the higher doses is even longer.

I also like that I can titrate up at my own pace in smaller than 2.5mg increments on compound/gray.

If it takes 12+ months for them to kill off compounding it is a good thing, Because as soon as they succeed I'll bet they go after the gray market next....
 
rkl123 said:
They want 1k per month whether you’re on tirz or Reta or any other drug really. Their end game is they make the drug as inaccessible as possible via alternative means. They’re banking on enough insurances coming on board that 1k a month (or some other negotiated value) would still net way more than Japan’s price
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Correct. LONG biz game.
 
GimmeABreak said:
This.

They are actively working with the PBM's and insurers to get it covered but patient copays could be higher than compound Tirz. If the cost is similar and a patient is on compound there is no incentive to switch and deal with insurance, constant doctor follow-up visits, hunting down your next dose when you can't refill before you're due for your next shot,

It is a serious PITA. My insurance covers it but I choose compound and have a stock of gray in the freezer. I throw the pens in the fridge for the future.

My 28 day script period was up on Monday but CVS wouldn't fill without my Dr submitting a prior authorization form. Jumped that hurdle and then CVS was out of stock. They send it to another CVS several towns over, then they ran out of stock. Finally got my 7.5 Zep on Thursday which would have been three days past my shot day. I hear the wait for the higher doses is even longer.

I also like that I can titrate up at my own pace in smaller than 2.5mg increments on compound/gray.

If it takes 12+ months for them to kill off compounding it is a good thing, Because as soon as they succeed I'll bet they go after the gray market next....
Click to expand...
They already started coming for the gray market with the Pivotal Peptides lawsuit and I’ve noticed a few other big names have stopped carrying it since.
 
Read in AARP mag, that EL wants Medicare to negotiate price for patients with Moderate to Severe Apnea. Availability in 2025. What is their endgame? To stay competitive, in many groups of audience. I don't really know the data of how many people are actually taking Tirzepatide becuase of not being able to afford Zepbound or Mounjaro. They have to realize that it is an elite population that can pay for Prescription Zep/Mounjaro private pay. And honestly, a bad gig of someone mis dosing themselves while doing Peps, or compounded, not under a PCP, and suffering ultimate consequence could cost them the company reputation and research, employment, everything. Some of us will do extreme due diligence to use our other opportunities, but I've seen a bit of willy nilly on other forums, and I'm afraid for some of the naivety that exists. People did not take their time to find the path. And, add to that, SOME Telehealth have also exposed greed, and people get sucked in. Having said all of that, 1K/ month was certainly not in my retirement budget, although I could do it, I choose to be conservative and sensible in my good decision to work with my PCP to use compounding and I"m not sure how she will feel about "gray" spectrum. I worked in a major corporation, and they all have their turn at trying to stay alive. Ok, enough.
 
GimmeABreak said:
This.

They are actively working with the PBM's and insurers to get it covered but patient copays could be higher than compound Tirz. If the cost is similar and a patient is on compound there is no incentive to switch and deal with insurance, constant doctor follow-up visits, hunting down your next dose when you can't refill before you're due for your next shot,

It is a serious PITA. My insurance covers it but I choose compound and have a stock of gray in the freezer. I throw the pens in the fridge for the future.

My 28 day script period was up on Monday but CVS wouldn't fill without my Dr submitting a prior authorization form. Jumped that hurdle and then CVS was out of stock. They send it to another CVS several towns over, then they ran out of stock. Finally got my 7.5 Zep on Thursday which would have been three days past my shot day. I hear the wait for the higher doses is even longer.

I also like that I can titrate up at my own pace in smaller than 2.5mg increments on compound/gray.

If it takes 12+ months for them to kill off compounding it is a good thing, Because as soon as they succeed I'll bet they go after the gray market next....
Click to expand...
How would they go after the gray market since it seems to come from CN? That country seems to do what they want and the rest of the world be damned.
 
70itch said:
Read in AARP mag, that EL wants Medicare to negotiate price for patients with Moderate to Severe Apnea. Availability in 2025. What is their endgame? To stay competitive, in many groups of audience. I don't really know the data of how many people are actually taking Tirzepatide becuase of not being able to afford Zepbound or Mounjaro. They have to realize that it is an elite population that can pay for Prescription Zep/Mounjaro private pay. And honestly, a bad gig of someone mis dosing themselves while doing Peps, or compounded, not under a PCP, and suffering ultimate consequence could cost them the company reputation and research, employment, everything. Some of us will do extreme due diligence to use our other opportunities, but I've seen a bit of willy nilly on other forums, and I'm afraid for some of the naivety that exists. People did not take their time to find the path. And, add to that, SOME Telehealth have also exposed greed, and people get sucked in. Having said all of that, 1K/ month was certainly not in my retirement budget, although I could do it, I choose to be conservative and sensible in my good decision to work with my PCP to use compounding and I"m not sure how she will feel about "gray" spectrum. I worked in a major corporation, and they all have their turn at trying to stay alive. Ok, enough.
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I'm on Medicare, and they absolutely will not pay for tirz for weight loss. I also have apnea, so if Medicare will negotiate to cover it for that use, then I could go through Medicare. I'm not holding my breath, tho. I'm going my own way and not waiting to see what happens. My goal is to build up my own stash in the deep freeze.
 
JKLIN said:
I'm on Medicare, and they absolutely will not pay for tirz for weight loss. I also have apnea, so if Medicare will negotiate to cover it for that use, then I could go through Medicare. I'm not holding my breath, tho. I'm going my own way and not waiting to see what happens. My goal is to build up my own stash in the deep freeze.
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On the Pen actually discussed the lawsuit against the peptide company but essentially they want to set a precedent for these situations to make it illegal. And the fact that Medicare won’t pay for it is BS.
 
Peachyp6369 said:
They already started coming for the gray market with the Pivotal Peptides lawsuit and I’ve noticed a few other big names have stopped carrying it since.
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I think the US pep retailers are low-hanging fruit for EL. Their legal department fires off a cease and desist letter and then the fun begins. I'm not an attorney but I suspect once you file a couple of lawsuits against these companies EL can almost put together a template so their cost per lawsuit is continually reduced. Most retailers don't have the financial resources to fight it and they will just close up shop or stop selling Tirz.

I am concerned that they will work with the Chinese government to put pressure on the raw peptide producers. From what I understand, there are only a few of them and the best way to shut/slow down the gray market is to go to the source.
 
rkl123 said:
They want 1k per month whether you’re on tirz or Reta or any other drug really. Their end game is they make the drug as inaccessible as possible via alternative means. They’re banking on enough insurances coming on board that 1k a month (or some other negotiated value) would still net way more than Japan’s price
Click to expand...
They can want $1000/mo but if hardly anyone can afford it they're not going to get it. If the average ACA plan costs a bit under $500/mo per Google and 40% of US adults have obesity, then for 1000 people they'd take in $500,000 and spend on average $400,000 on weight loss drugs every month. I'm not exactly a fan of insurance companies but that does not seem sustainable.

Granted, some people might not want the meds but if even half do that's still a substantial portion of their budget. They might be able to make it work if they added more restrictions, like a higher BMI limit or comorbidities, but that would also decrease the long term benefits since that means waiting until people have more problems to start treatment. You'd also have people constantly cycling on and off the meds as they lose enough weight to no longer qualify and then regain it. It just doesn't look like it would work without a more reasonable price.
 
aloil said:
They can want $1000/mo but if hardly anyone can afford it they're not going to get it. If the average ACA plan costs a bit under $500/mo per Google and 40% of US adults have obesity, then for 1000 people they'd take in $500,000 and spend on average $400,000 on weight loss drugs every month. I'm not exactly a fan of insurance companies but that does not seem sustainable.

Granted, some people might not want the meds but if even half do that's still a substantial portion of their budget. They might be able to make it work if they added more restrictions, like a higher BMI limit or comorbidities, but that would also decrease the long term benefits since that means waiting until people have more problems to start treatment. You'd also have people constantly cycling on and off the meds as they lose enough weight to no longer qualify and then regain it. It just doesn't look like it would work without a more reasonable price.
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ACA is the low end of the market. They’d rather get 1 “whale” at 1k than 10 at 100. It isn’t about health or equity or anything else. It is about milking as much as they can get by whatever combo they think maximizes
 
rkl123 said:
ACA is the low end of the market. They’d rather get 1 “whale” at 1k than 10 at 100. It isn’t about health or equity or anything else. It is about milking as much as they can get by whatever combo they think maximizes
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That does seem to be what they're thinking, and maybe they can make more money that way. I'd intuitively think whales would be relatively rare among their target population, but they've done the math.

I'm mostly just angry that they have a miracle drug, price it ludicrously out of reach for most people (at least in the US), and then have the gall to complain about the obvious consequences. They could have priced it for the masses and still made a huge profit but chose not to. It seems pointless and deliberately cruel to go after the alternatives people who can't afford their price turn to when they were the ones to choose to make the legit route inaccessible.
 
It'll go like this...

They will introduce reta as their premium offering. And then keep lowering the price of tirz when you use the coupon/lilly direct if your insurance denies it. Rinse and repeat. They'll go after anyone and everyone until their patent expires.
 
nccane said:
It'll go like this...

They will introduce reta as their premium offering. And then keep lowering the price of tirz when you use the coupon/lilly direct if your insurance denies it. Rinse and repeat. They'll go after anyone and everyone until their patent expires.
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I disagree. Unless cagrisema or something else challenges them, they have both of the superior drugs (a pseudomonopoly). Their greedy interest is to have BOTH tirz and Reta be very very expensive.
 
rkl123 said:
I disagree. Unless cagrisema or something else challenges them, they have both of the superior drugs (a pseudomonopoly). Their greedy interest is to have BOTH tirz and Reta be very very expensive.
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I didnt say it would be cheap. Just that the price would lower. They can be at compound prices and people would buy the shit out of it. They've already lowered their voucher price before. There's so many glps that will flood the industry in 26/27
 
rkl123 said:
I disagree. Unless cagrisema or something else challenges them, they have both of the superior drugs (a pseudomonopoly). Their greedy interest is to have BOTH tirz and Reta be very very expensive.
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These branded weight loss drugs will only get significantly cheaper when there are at least 4 or 5 different options which are produced by 4 or 5 different pharmacy companies and all work about equally well for most people.
 
TroyLPN said:
These branded weight loss drugs will only get significantly cheaper when there are at least 4 or 5 different options which are produced by 4 or 5 different pharmacy companies and all work about equally well for most people.
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Bingo. And the insurance companies will continue to tighten their guidelines on what they will cover. These pharma companies know their money is coming mostly from people who want to lose weight, not those with medical conditions. They lower the cost to get vials in hands and compete. Think there's 8 glp 1s that should arrive in 26/27.
 
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ELI can't keep up with demand with the product priced $600-$1400/mo.

If you were running a business and could not keep up with demand would you lower your price or raise it to moderate the demand until you are able to add production capacity? ELI is a public company that answers to shareholders and their goal will always be to maximize the return for shareholders. What I don't understand is why they have it priced so low outside of the US. Someone posted on reddit a few weeks ago that they are in Poland and the cost was like $150 and no prescription needed??
 
Th
TroyLPN said:
These branded weight loss drugs will only get significantly cheaper when there are at least 4 or 5 different options which are produced by 4 or 5 different pharmacy companies and all work about equally well for most people.
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The crucial question is which if any are actually good enough to challenge tirz or Reta. More sema tier drugs means EL keeps pseudo monopoly status.
 
rkl123 said:
Th

The crucial question is which if any are actually good enough to challenge tirz or Reta. More sema tier drugs means EL keeps pseudo monopoly status.
Click to expand...

People are overlooking Mazdutide but that another Lilly controlled drug that won't change this dynamic at all and it won't be approved in the US for a while.

Pemvidutide and MariTide are the real outside challengers. I've already expressed my concerns about the fact that MariTide is long acting, but Pemvidutide appears to be better than Reta.
 
rkl123 said:
They want 1k per month whether you’re on tirz or Reta or any other drug really. Their end game is they make the drug as inaccessible as possible via alternative means. They’re banking on enough insurances coming on board that 1k a month (or some other negotiated value) would still net way more than Japan’s price
Click to expand...
This here.
 
noteablequotable said:
People are overlooking Mazdutide but that another Lilly controlled drug that won't change this dynamic at all and it won't be approved in the US for a while.

Pemvidutide and MariTide are the real outside challengers. I've already expressed my concerns about the fact that MariTide is long acting, but Pemvidutide appears to be better than Reta.
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There’s also that Oljdifjdnejd one. It has a section on this forum. Further, Viking Pharmaceuticals V83738283 is getting through.
Lilly is def trying to bank what they can for now
 
Peachyp6369 said:
www.onthepen.com

OTP Exclusive: Lilly Has Been Quietly Exploring Alternative Avenues to Shut Down Tirzepatide Compounding

In an exclusive interview last night with Scott Brunner, CEO of the Alliance for Pharmacy Compounding, we uncovered a bombshell: Eli Lilly has been working quietly but diligently on additional means to remove compounded versions of tirzepatide—the active ingredient in Mounjaro and Zepbound—from...
www.onthepen.com www.onthepen.com

They’ve been trying to say it’s a demonstrably difficult compound since August. But it’s obvious no one can afford it and by next year better drugs will be available so it’s almost like they don’t want people on it? What a truly weird way to drive people away. They could make it affordable and make so much more money. This drug costs $84 in Japan so it’s not like it’s costly to manufacture. Am I missing something here? Do they really think people will pay $1000 a month for it?
Click to expand...
My health insurance pays a large of money for me to take Zepbound. Supposedly they pay about $650 every four weeks for it, although with pharmacy benefit managers and the weird way they do things, I know that it pays less for it. However, while you say that no one will pay for Zepbound, many individuals and insurance companies already are.

My lay opinion is that the FDA won't go along with semaglutide and tirzepatide being difficult to compound. They're actually quite easy to compound. Both Novo and Lilly submissions includes deaths reported to the FDA Federal Adverse Event Reporting System (FAERS), a system includes any reports of deaths made by anyone. No confirmation is required before being inputted into the data pool. Thus, to accept that compounded semaglutide caused many deaths, you'd also need to accept that Wegovy caused a larger number of deaths. (I haven't actually looked up the data on Zepbound, but I expect it to be similar.)
 
aloil said:
People big enough to qualify for a prescription for a weight loss drug. Unless they want to focus on people who are already at or near a healthy weight and want to be thinner.
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They want to focus on whoever is willing to pay exorbitant prices. And that is a HUGE market, I would casually say that's nearly everybody, from the over 40 BMI "whales" to people who just want to lose 15-20 lbs and have the $$ to spend. There is no shortage of people willing to pay anything for a weight loss drug that works.
It's price-gouging, plain and simple, and this country's "healthcare" system is so corrupt that they refuse to make laws limiting this abuse against public health.
 
Amusingly enough I had never even heard of compounding pharmacies before the Eli Lily lawsuit. Once I learned about them and found one I trusted and started doing more research I discovered all of this. I feel like the publicity they're giving the grey market is just going to raise more awareness and more people are going to dive in.
 
nccane said:
It'll go like this...

They will introduce reta as their premium offering. And then keep lowering the price of tirz when you use the coupon/lilly direct if your insurance denies it. Rinse and repeat. They'll go after anyone and everyone until their patent expires.
Click to expand...
Based upon what I've observed with other drugs, Lilly won't lower their price for Zepbound when retatrutide comes out.
 
More competition is coming in the next 2-3 years. They will be forced to lower prices to compete for market share. I expect Tirz to be their "low cost" medication, while Reta is the "premium" product for those who can afford it.
 
m100568 said:
More competition is coming in the next 2-3 years. They will be forced to lower prices to compete for market share. I expect Tirz to be their "low cost" medication, while Reta is the "premium" product for those who can afford it.
Click to expand...

Based upon what I've observed with other drugs, Lilly won't lower their price for Mounjaro/Zepbound when retatrutide comes out. Novo won't lower its price for Ozempic/Wegovy when cagrilintide/semaglutide comes out.
 
Viking and Amgen are both in Phase III. Worldwide there are over 100 peptides being explored. It is a gold rush. It may take longer than 2-3 years, but competition is coming. It won't just be 2 players seeing how high they can keep the prices. So, according to Lilly, in the meantime you need to either pay up or stay fat and sick. I don't think that they realize how much hatred for them they are creating. Some day, when people have a choice, they will remember what Lilly did.
 
keangkong said:
Based upon what I've observed with other drugs, Lilly won't lower their price for Mounjaro/Zepbound when retatrutide comes out. Novo won't lower its price for Ozempic/Wegovy when cagrilintide/semaglutide comes out.
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Exactly. The price for Ozempic actually went up in Jan 2024, right after Zepbound was approved. They won't compete against themselves or each other. Plus PBMs have been known to drop lower price options because it means they get less in fees. There's not the market pressure here that could otherwise work.
 
I am a bit of a contrarian here (caveat: I don't have any specific industry expertise).
1) Insurance companies will only cover a small part of the (huge) addressable market and only for limited durations
2) Therefore, this class of drugs will become a consumer product, where the patient, not the physician drives the purchase made with their own money
3) This will drive prices down as supply constraints are alleviated and new competitors come online, the consumer market will still be very profitable at let's say $300/month vs. $1000/month and someone will step in and take that market.
4) The grey market will exist, not because big pharma is benevolent, but because it will never become more than a tiny fraction of the addressable market and will be prohibitively expensive to try and eradicate. In the US I am pretty sure that DHS will not be excited by having a bunch of its budget moved from border security to trying to find small vials of unregulated substance shipped by small Chinese vendors. Yeah, if its Fentanyl they care for obvious reasons, but I think the most we get in this market is a bit of "security theater" that scares potential buyers and makes it a bit harder and more expensive to acquire to keep the grey market smaller.
 
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