If you want to sell me a healthcare strategy, don’t send a pharma to convince me.
On a scale of 1-10 on the cynicism spectrum, journalists come in at about 15.5, and I am no different, I’m afraid.
So, when a new white paper lobs into my inbox declaring “the need for public funding of anti-obesity medications”, and that white paper has been commissioned by Eli Lilly Australia, my immediate reaction is “yeah, nah”.
Lilly, of course, is the maker of tirzepatide, otherwise known as Mounjaro, a GLP-1 receptor agonist, the blockbuster new class of weight-loss drugs.
It’s currently listed as a drug in shortage in Australia, and is only approved for use as a treatment for type 2 diabetes, and not for weight loss. Lilly also makes dulaglutide (Trulicity), another type 2 diabetes treatment which can cause weight loss, but is not approved for that use in Australia.
So perhaps it’s not surprising that Lilly would back a call for public funding of the very drugs it, and its competitor Novo Nordisk, are making an absolute bucketload of money from.
Perhaps I’m being unfair.
The white paper — Reframing weight management: evolving the narrative around anti-obesity medications and prioritising care – is available on Lilly’s website, and it’s full of facts.
Two-thirds of Australian adults are living with overweight or obesity – Australia’s second leading contributing factor for ill health and death after tobacco use, and 8.4% of Australia’s total disease burden.
So says the Australian Institute of Health and Welfare, and the Obesity Evidence Hub.
Overweight and obesity is associated with 30 non-communicable diseases and without action it is estimated to cost the Australian healthcare system $87.7 billion by 2032, according to the DoHAC’s National Obesity Strategy 2022-2032.
The media release with the white paper says this:
“The latest generation of anti-obesity medications have the potential to revolutionise outcomes for people living with obesity and overweight in Australia.
“Five medicines for obesity treatment are currently registered in Australia. However, to date, none of the approved medicines have been listed on the Pharmaceutical Benefits Scheme (PBS) for overweight and obesity management.
“The successful integration of these medications into obesity management requires robust support systems for primary care services and equitable access to ensure the best long-term outcomes for people living with overweight and obesity.”
At the risk of being a bit to patient-y for an HSD audience, I’m a person with lived experience of obesity.
I’ve tried everything. Literally, everything. And the only result was to get fatter.
I hit my late 50s and recognised I was dying faster than I needed to, farmed my superannuation so I could get private bariatric surgery, lost 75kg and 2.5 years on, remain optimistic that I can keep most of that off.
Don’t try and tell me that the “latest generation of anti-obesity medications” are the silver bullet.
I’m not saying weight-loss interventions shouldn’t be funded by the government. They absolutely should be. I’ll talk to you until the cows come home about whether bariatric surgery should be more available in the public hospital system so people don’t have to pillage their retirement savings to pay the out-of-pockets.
I’m just saying, don’t swallow the weight-loss medication Kool-Aid just yet. We’ve been here before. Remember fen-phen and the damage it did to heart valves? Dulaglutide had its moment in the sun as well, with mixed results.
GLP-1 RAs come with challenges for the health system – script mills, compounding bans, petitions against compounding bans. Mix that all in with the scope of practice review, SIMPs, telehealth and shortages and we’re buying into a world of complications, here.
All I’m saying is, let’s sort out the infrastructure and the long-term safety profiles before we dive into the pool of magic bullets for weight loss.