What is EL’s endgame here?

[Peachyp6369]

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

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?

 

[MarisWinter]

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

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?

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.

 

[rkl123]

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

 

[Peachyp6369]

I wonder if insurance will cover it eventually. Mine won’t even discuss it even on appeal. My doctor tried to appeal it and my insurance company said it was nonnegotiable so I started to look for other methods. That’s all they’re going to end up doing is driving people away.

 

[GimmeABreak]

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

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....

 

[MarisWinter]

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

Correct. LONG biz game.

 

[Peachyp6369]

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....

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.

 

[70itch]

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.

 

[JKLIN]

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....

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.

 

[JKLIN]

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.

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.

 

[Peachyp6369]

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.

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.

 

[GimmeABreak]

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.

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.

 

[delululemonade]

I'm not holding my breath, tho.

Except when you sleep!

Ba-dum-tssss

 

[JKLIN]

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.

Medicare also won't pay for dental or eye care or hearing aids, either. Total BS.

 

[aloil]

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

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.

 

[rkl123]

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.

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

 

[aloil]

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

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.

 

[TrundleBundle]

I'd intuitively think whales would be relatively rare among their target population

For a weight loss drug?

 

[aloil]

For a weight loss drug?

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.

 

[noteablequotable]

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.

Big enough to qualify and stuck on it forever.