Weight list: The rush for access to weight loss drugs is not just in the United States. 20,000 people were interested in Wegovy in Britain and the wait list (weight-list?) is long. Ozempic is in shortage there. Another story highlighted shortages for weight loss drugs in United Arab Emirates. Interestingly, each area in the UAE has its own regulations; 5 of the 7 emirates sell Ozempic over the counter.

Telling the list/net price story — rebates: This week GAO put out a report that said that pharmaceutical manufacturers provided almost $50 billion in rebates in 2021. About ¾ of them were from diabetes, blood modifier and respiratory drugs. Take a look at the list of drugs about to be negotiated. Think that rebates will be impacted?

Astellas out, AZ in: Xtandi out and so is Astellas in the IRA lawsuits. Interesting idea – AZ is proposing that the clock for negotiation start at the first non-orphan approval, not just overall FDA approval date.

Inner IRA Monologue: Larry Levitt from the Kaiser Family Foundation writes for the NYT on arguments against Medicare drug pricing. I immediately wrote bullet points in response. All except for negotiated prices help the government, not patients. I mean it likely helps both, but patients might not notice with the new Part D out-of-pocket cap of $2,000.

RSV: RSV vaccine awareness is really low. Combine that with the inability of physicians to give the vaccines (it’s Part D) and I don’t like the COVID/flu/RSV season that is about to happen.

Patent Incentives: A healthy debate was had at the breakfast table about the NYT Daily story on drug patents and the incentives they create. It doesn’t feel right, but I also can’t say it is wrong. My 13-year-old declared it the nerdiest conversation he’s ever heard and said that no one should use the word ethical over Cheerios.