Compounded GLP-1 meds, chronic kidney disease outcomes, Walmart woes, and World Pet Obesity Awareness Day.

Hello all,

It continues to be a fascinating, rapid and intense period of development in obesity and metabolic medicine. We learn something new virtually every week; we are very much looking forward to Obesity Week in Dallas, TX and the latest developments in evidence-based obesity science and treatments.

In this Weekly Roundup, we have interesting articles including Novo Nordisk stopping their kidney outcomes trial FLOW; concerns of processed food companies that make sweet and salty snacks; the increasing numbers of employers potentially willing to cover GLP-1 drugs; Novo Nordisk’s lawsuit against compounding pharmacies being dismissed; and more on the bias and stigma associated with obesity. And….. World Pet Obesity Awareness Day.

Kind regards, Raj

AT A GLANCE

  • Accolade, ‘…a company that provides healthcare programs for employers, and research firm Savanta said 43% of the employers it polled could cover GLP-1 drugs in 2024 compared to 25% that cover them now…’ from Reuters.
  • Ed Silverman at STAT News notes a U.S. judge dismissed a Novo Nordisk lawsuit ‘…accusing a compound pharmacy of selling versions of its Wegovy and Ozempic medicines.’
  • ‘Novo Nordisk today announced the decision to stop the kidney outcomes trial FLOW…’ on the effect of GLP-1 medication semaglutide versus placebo on the progression of renal impairment in people with type 2 diabetes and chronic kidney disease [CKD].
  • Jane Sarasohn-Kahn, health economist, advisor and trend-weaver supporting organizations at the intersection of health, technology and people, reviews ‘…concerns of companies that stock the-middle-of-the-grocery-store aisles for processed foods like sweet and salty snacks.’
  • The Association for Pet Obesity Prevention (APOP) and the World Pet Obesity Association (WPOA) announced October 11, 2023, is World Pet Obesity Awareness Day.
  • ‘People living with obesity report experiencing bias and stigma linked to their condition across numerous settings…’ write Drs. Kyle, Kahan and Nadglowski in Gastroenterology Clinics of North America.

NEWS

  • Companies are ‘…investing billions of dollars to expand or build factories that fill the injection pens used to administer treatments like Novo Nordisk‚Äôs Wegovy…’ as per Maggie Fick at Reuters. WuXi Biologics CEO Chris Chen noted utilization of German factory purchased in 2020, Catalent to employ factories in Anagni, Italy and Bloomington, Indiana, and Thermo Fisher is converting facilities used to fill COVID-19 vaccine syringes to handle pens for obesity and diabetes medicines.
  • Accolade, ‘…a company that provides healthcare programs for employers, and research firm Savanta said 43% of the employers it polled could cover GLP-1 drugs in 2024 compared to 25% that cover them now…’ from Reuters. Accolade Associate Chief Medical Officer James Wantuck advocates for ‘…a physician-led approach that guides who should be prescribed GLP-1 medications and how to make them part of a holistic health management plan.’
    • In both an alarming though understandable situation, ‘…Benefits consultant Aon said a full one (1) percentage point of the 8.5% increase in employer healthcare costs it predicted for next year would be driven by employee take-up of weight-loss drugs.’
  • Ed Silverman at STAT News notes a U.S. judge dismissed a Novo Nordisk lawsuit ‘…accusing a compound pharmacy of selling versions of its Wegovy and Ozempic medicines.’ Novo argued ‘…the compounders were selling versions of its medicines that were never approved by the U.S. Food and Drug Administration.’ Scott Brunner, who heads the Alliance for Pharmacy Compounding, a trade group, wrote that ‘…clearly, by granting the defendant’s motion to dismiss, the judge agreed that the allegations in the case lacked merit. Ridiculous is what I would call those allegations.’
  • The Association for Pet Obesity Prevention (APOP) and the World Pet Obesity Association (WPOA) announced October 11, 2023, is World Pet Obesity Awareness Day. They ‘…encourage all veterinary professionals and pet owners to measure their pets’ health by performing a body condition score (BCS), weighing their pets, and calculating daily calories to feed.’ In 2022, the State of Pet Obesity Report finds ‘…59% of dogs and 61% of cats classified as overweight or have obesity.’ Dr. Ernie Ward, founder and president of APOP states ‘…One of the biggest challenges veterinarians in every country face is getting pet owners to recognize when their pets are overweight or have obesity.’
  • ‘Novo Nordisk today announced the decision to stop the kidney outcomes trial FLOW…’ on the effect of GLP-1 medication semaglutide versus placebo on the progression of renal impairment in people with type 2 diabetes and chronic kidney disease [CKD]. The independent data monitoring committee concluded that results from an ‘…interim analysis met certain pre-specified criteria for stopping the trial early for efficacy…’ with a read out of the results during the first half year of 2024.
    • This is exciting news, and essentially means that the outcomes for the intervention group were so positive, that it may be deemed unethical to continue to treat the placebo group without the intervention medication. The trial sought to demonstrate a ‘…delay in progression of CKD and to lower the risk of kidney and cardiovascular mortality.’

OPINION

  • Tressie McMillam Cottam writes ‘Ozempic, Wegovy and Mounjaro are part of our public lexicon…’ and ‘…promise to rid the United States of obesity, if our country can figure out how to make the pricey fix affordable…’ in a New York Times Opinion piece. Going from ‘wonder drugs’ to ‘…a social problem that one miracle drug cannot fix…’ is a vast canyon, further fueled by an ‘…the anti-obesity gold rush… like the gold nugget that lured miners out West.’
    • I do love the narrative that the ‘… cultural conversation around Ozempic is as obsessed with celebrities as the celebrities are obsessed with themselves…’ such that ‘…the rich, famous and near famous were getting skinnier.’
    • Dr. Richard Kahn, the former chief scientific and medical officer at the American Diabetes Association states the obvious on GLP-1 meds ‘…that they cost an enormous amount of money.’
    • In furtherance, the author simply writes ‘…cash-strapped American consumers are left to contend with a society in which the price of being fat is so high that there will always be a rational reason to pay an exorbitant amount to be thin.’
  • ‘People living with obesity report experiencing bias and stigma linked to their condition across numerous settings…’ write Drs. Kyle, Kahan and Nadglowski in Gastroenterology Clinics of North America. In addition, the ‘…social stigma of obesity interferes with quality of life, educational attainment, economic security, and access to effective health care.’ The ‘…impressive wave of public attention to the subject of obesity and its treatment…’ leads to ‘…confusion between a medical understanding of obesity, for which these medicines are intended, and cultural notions about body weight, body image, and weight loss.’
    • The three authors are luminaries in the field of obesity medicine, and whilst the descriptive nature of their article that ‘…frames obesity in ways that are person centered, scientifically accurate, easily understood, and limits risk of bias…’ is valuable narrative, the approach to put such work into action is a major challenge.
  • Jane Sarasohn-Kahn, health economist, advisor and trend-weaver supporting organizations at the intersection of health, technology and people, reviews ‘…concerns of companies that stock the-middle-of-the-grocery-store aisles for processed foods like sweet and salty snacks.’ Jane, who is also a good friend, notes how ‘…the likes of the makers of Pringles and Oreos are in the throes of re-thinking and making snack foods and other products that some consumers aren’t filling their baskets with…’ in light of explosive use of GLP-1 drugs by its consumers.
  • Dr. Oliver Eitelwein and colleagues at Oliver Wyman note that the ‘…sudden and meteoric rise in use of new weight-loss drugs put a spotlight on obesity prevention.’ Indeed, a ‘…set of interconnected challenges face patient segments, including lack of awareness around health risks, pervasive stigma, inadequate treatment coverage, and limited long-term monitoring options.’
    • Obesity treatment challenges are bucketed into disease awareness, diagnosis, treatment initiation, and long-term monitoring.
    • Approaches to address the stigma of obesity being a lifestyle issue to greater access to digital tools, behavioral support, and other complementary services, in addition to interventions like GLP1s.

DATA

A light section this week, though expect much more next week once we hear the abstract presentations from Obesity Week 2023 in Dallas, TX.

Kind regards, Raj

DR.RAJESH TWENTLY 30 HEALTH

 

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