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Monday, February 12, 2024

Ozempic Will Change Healthcare as We Know It

The appearance on the market (finally!) of a weight-loss drug with relatively few side effects is a huge deal. It has changed peoples’ lives, the healthcare industry and has even generated repercussions in the business world, with more to come.

A number of studies have begun to highlight the broad ranging benefits offered by Ozempic and similar drugs, known as GLP-1 receptor agonists. Apart from the ability to induce weight loss and thus reduce the risk of associated ailments, the medicine seems to offer benefits to the heart, liver, and kidneys. GLP-1 receptor agonists (semaglutide) appear to help combat substance abuse and fight the neuroinflammation and oxidative stress that contribute to Alzheimer’s.

“I don’t think any of us had the vision that, 40 years later, we would be thinking about all of these different actions of GLP-1,” says Daniel Drucker, a University of Toronto professor who helped discover how the drugs work. “It took a tremendous amount of work over decades to really get us to where we are now.”

Other Uses Have Unexpected Effects

A mere six years after its introduction, Ozempic has become the top-selling prescription drug in the US. The more uses that are found for the drug while it’s still on patent, the better for maker Novo Nordisk. But it’s not a boon for all companies. When Ozempic was found to be so effective at fighting kidney disease that a trial was stopped early, the stock of dialysis providers Fresnius Medical Care AG and DaVita Inc. took a $3.6 billion hit. 

“The market has reached a point of near peak hysteria regarding the impact of GLP-1s,” wrote Matthew Taylor, an analyst who covers medical-device stocks for Jefferies LLC. “The carnage in medtech has been notable, and broad, almost indiscriminate, impacting names that seemingly have no perceived linkage to GLP-1s.”

Heart Disease

Take cardiovascular disease as one example. Americans dole out around $250 billion per year for blood pressure drugs, bypass surgery, and implantable cardiac devices like pacemakers. Recent studies have shown that semaglutide therapy improved symptoms “significantly” in participants who were obese. 

“We’re now at the precipice of this avalanche of data that really point us in the direction saying obesity is what’s causing these complications. In order for us to effectively manage these complications, we have to address obesity, we have to target obesity,” says Dr. Mikhail Kosiborod, a cardiologist, vice president of research at Saint Luke’s Health System, and lead author of the study. 

Changing Appetite

Other industries have noted changes as well. Semaglutide decreases hunger, and there are so many people using them that major food retailers are seeing changes in patterns of consumption. 

"We definitely do see a slight change compared to the total population, we do see a slight pullback in overall basket," says Walmart U.S. CEO John Furner. "Just less units, slightly less calories."

It looks like the number of people taking the drug is only going up. In a recent report, Morgan Stanley Research analysts estimate that 24 million people, or 7% of the US population, will be on the drug by 2035. 

“The food, beverage and restaurant industries could see softer demand, particularly for unhealthier foods and high-fat, sweet and salty options," notes Morgan Stanley tobacco and packaged food analyst Pamela Kaufman. “We acknowledge that the impact in the near term is likely to be limited given drug adoption will grow gradually over time, but we could see a longer-term impact as drug prevalence increases. Moreover, we expect companies to adapt to changes in consumer behavior through innovation and portfolio reshaping efforts."

Exercise Jumps

While pizza chains may become scarce, other industries could benefit. Morgan Stanley Research found that GLP-1 users exercised more than before they were taking the drug. In fact, the number who exercised on a weekly basis fully doubled. 

“Perhaps as patients lose weight, they simply feel both more physically able and more mentally motivated to exercise more to compound the benefits they are seeing from weight loss medications," writes Morgan Stanley analyst Brian Harbour.

Curbing Cravings

It’s not only food cravings that seem to be kept in check by semaglutide. People taking the drug are reporting that they’re no longer interested in alcohol, that they’ve stopped smoking, that their impulse to shop has gone away and they’re no longer biting their nails. Researchers have a trio of theories about why this may be happening.
  • A change in the sense of smell and taste
  • A change in the part of the brain linked to pleasure and reward
  • An increased avoidance of certain chemicals such as those found in alcohol and cigarettes

To date, not much research has been done on the subject. And scientists theorize that the effect may dissipate and disappear when someone quits taking the drug. 

“Unless the emotional issues are addressed, removing the substance will do little more than create a dry drunk,” says Laura Lee Wright, a sober living coach. “It’s dangerous to suggest there is a magic pill that can make an addict well.” She recommends group therapy, mental and emotional counseling, and residential rehab to treat addiction. 

Perhaps semaglutide will be used in future to kickstart a more traditional program of drug therapy. And if a significant portion of the population is on it, will liquor stores feel the pinch? Will the opioid crisis finally die out? Will shopping as a whole go down? 

The answers to these questions, like so many with the new weight-loss drugs, are yet to be seen. But there is reason for optimism on many fronts.