annual report <\/a>for 2023 paint a grim picture of their impact on the island.<\/p>\nInsurance claims related to diabetes for the financial year 2020-21 topped $3.5 million, with obesity payouts at more than $650,000.<\/p>\n
The report showed 38.4 per cent of people aged 35 to 64 were classed as obese in 2023.<\/p>\n
The Black population was worst-hit, at 36.8 per cent, compared with 30.3 per cent of the White population.<\/p>\n
Ms Bosch de Noya told The Royal Gazette: \u201cAny effective diabetes medication, as any endocrinologist would tell you, has to have an outcome of weight loss.<\/p>\n
\u201cIf a diabetes drug, which we had 20, 30 years ago, was good at lowering glucose levels but caused weight gain, at the end of the day it\u2019s only going to increase insulin resistance and not make the diabetes outcome better.<\/p>\n
\u201cBut when people realised that these new classes of drug cause weight loss, it activated everybody\u2019s interest in using these drugs for weight loss.\u201d<\/p>\n
Drugs such as Ozempic can be far from perfect, as a 54-year-old Black man who struggled over decades to shed excess pounds attested.<\/p>\n
\u201cI lost five pounds over two, three years, but it was weird,\u201d he said.<\/p>\n
\u201cIt made chicken taste funny, so I couldn\u2019t eat chicken.\u201d<\/p>\n
His interest in drinking alcohol also vanished \u2014 but in ways that felt \u201cstrange\u201d.<\/p>\n
\u201cIt was like that was removed as an option for me to have,\u201d he said. \u201cTowards the end, I started to have stomach pains, so I just quit it.\u201d<\/p>\n
Most patients get started with Ozempic, according to Ms Bosch de Noya.<\/p>\n
Those who react badly could get switched up to Mounjaro, which she described as \u201ca slightly ramped-up version \u2014 the main difference is that it activates two gut hormones that regulate blood sugars, whereas Ozempic is just one\u201d.<\/p>\n
She added: \u201cWe\u2019re seeing a few that might get switched to Mounjaro, particularly people who don\u2019t tolerate Ozempic, where they might have some nausea or gastrointestinal symptoms.<\/p>\n
\u201cThere are anecdotal cases I\u2019ve seen with patients where they\u2019ve switched to Mounjaro and don\u2019t have those same symptoms. It\u2019s still a once-a-week drug.\u201d<\/p>\n
Bermuda\u2019s health insurers vary, but Mr Lozier spelt out the Argus approach.<\/p>\n
\u201cOzempic is approved to treat type 2 diabetes, reduce heart risks in people with diabetes and heart disease, and, starting in 2025, help slow kidney disease in those with diabetes,\u201d he said.<\/p>\n
Its active ingredient, semaglutide, is exactly the same as that contained in another drug, Wegovy \u2014 but only the latter, approved for weight loss, is covered by the insurer, which adheres to the book when it comes to deciding coverage.<\/p>\n
In that regard, Mr Lozier said that Ozempic, if prescribed for weight loss without a medical diagnoses, would not be covered under the company\u2019s plans.<\/p>\n
Ms Bosch de Noya said she supported such vetting of payment by insurers.<\/p>\n
\u201cPeople who have diabetes, generally there isn\u2019t an issue with it,\u201d she said.<\/p>\n
\u201cSome of the insurance companies may require more of pre-authorisation, particularly with Mounjaro, because it\u2019s more expensive. And rightly so \u2014 there should be some level of pre-authorisation with both of them.\u201d<\/p>\n
Regardless, Mr Lozier said, the island\u2019s demand for the medications was increasing.<\/p>\n
Monthly use of the drugs \u201csurged by nearly 600 per cent between 2020 and 2023 for individuals under 25, and 300 per cent for those over 25\u201d.<\/p>\n
Mr Lozier said the monthly cost for Ozempic in Bermuda ranged from $936 to $1,300, \u201csignificantly higher than in regulated markets\u201d.<\/p>\n
The company estimated the annual cost per patient at about $10,00.<\/p>\n
Mr Lozier said generic versions of the drugs stood to bring down costs \u201csignificantly\u201d.<\/p>\n
He added: \u201cHowever, a generic version of Ozempic isn\u2019t expected in the US until late 2031 or early 2032.<\/p>\n
\u201cIn Canada, the semaglutide patent expires in January 2026, and several companies are expected to launch generics. Pending approval, these could lower the monthly costs by more than 50 per cent.\u201d<\/p>\n
Annabel Fountain, an endocrinologist with many years of experience with the medications, questioned Argus\u2019s figures for cost, maintaining that she had seen substantially cheaper deals for the treatment described.<\/p>\n
Her advice to patients was: \u201cCall around and see how much it costs elsewhere.\u201d<\/p>\n
Dr Fountain said use of the drugs was best undertaken with education on nutrition and a study of individual body composition.<\/p>\n
She said their results were \u201camazing\u201d when properly deployed with attention to diet and fitness.<\/p>\n
\u201cSeventy-four per cent of us are overweight or obese,\u201d Dr Fountain said. \u201cThe biggest health problem we have in Bermuda is diabetes and obesity.<\/p>\n
\u201cOncologists and cardiologists will agree. If we could prevent people from becoming obese or developing diabetes, we would have significantly less cancer or heart disease.\u201d<\/p>\n
Dr Fountain said the weight loss triggered by the drugs could be a catalyst for the lifestyle changes required to eventually come off them.<\/p>\n
\u201cIf your knees hurt when you\u2019re 250 pounds, it\u2019s hard to exercise,\u201d she said. \u201cBut if you were to lose 50 pounds, it\u2019s easier to exercise. It becomes a positive snowball effect.\u201d<\/p>\n
Dr Fountain agreed that the emergence of cheaper, generic versions of the drugs held some promise for cutting costs, but said pricing on the island needed to be regulated.<\/p>\n
\u201cIf a wholesaler brings it in, and it only costs them $10, they can still charge people $100 for it \u2014 there\u2019s no regulation at the moment.\u201d<\/p>\n
She said the development of a national drug formulary similar to Britain\u2019s, now under way in Bermuda, would bring much needed precision to the prescription of drugs.<\/p>\n
She added: \u201cPotentially, there will be regulation in the future of the price of medications.\u201d<\/p>\n
Ms Bosch de Noya, whose focus is on diabetes, said she was optimistic that the medications could help to turn the tide on a host of chronic and debilitating diseases linked to the problem.<\/p>\n
\u201cAre we winning the war on it yet?\u201d she said.<\/p>\n
\u201cThat still remains an outcome for us to watch and wait for, but that\u2019s our hope \u2014 that with the improved outcomes, we will certainly see less of the devastating complications that we used to see with diabetes.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"New tools in healthcare: diabetes medications Mounjaro, left, and Ozempic, both of which are kept refrigerated at the…\n","protected":false},"author":2,"featured_media":57808,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4316],"tags":[30333,967,105,4348,445,16,15],"class_list":{"0":"post-57807","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-bermuda-diabetes-association","9":"tag-diabetes","10":"tag-health","11":"tag-healthcare","12":"tag-obesity","13":"tag-uk","14":"tag-united-kingdom"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/114416344456885124","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/57807","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=57807"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/57807\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/57808"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=57807"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=57807"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=57807"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}