Ozempic, Wegovy & others: We’ve Seen This Movie Before.
When I was ten years old, the country was crazy over Cyclamate. It was the perfect artificial sweetener. It tasted just like sugar without the vile aftertaste of Saccharin. In 1969, Cyclamate was in everything. Flintstone vitamins, Kool Aid, soda, and basically anything where sugar could be easily replaced. It seemed like a safe and healthy alternative. Yet, just one year later, Cyclamate was banned, accused of causing cancer. Many in this country blamed the sugar lobby (which is certainly likely). Interestingly, the drug is still considered safe in the European Union.
In the early 1990’s, we discovered Fenfluramine and Phentermine as a weight loss combination. It was rather remarkable. People felt great and they dropped a lot of weight. Even today, patients speak longingly of the combination. Of course, the combination was also quietly wrecking heart valves and lawyers everywhere made a lot of money.
In the late 1980’s, statins appeared and various medical groups advised them for almost everyone walking into the office. For many years, I was a serious skeptic, but I was proven mostly wrong. Statins do have some significant problems, but they are also remarkable in their ability to reduce heart attacks in high risk patients. More than three decades later, I cannot imagine they will ever disappear.
Remember PremPro? Remember how it was considered malpractice in the 1990s to not give this to every menopausal female? Hmmm… Looks pretty silly today. Doesn’t it?
Now, we have the GLP-1 Receptor Agonists as the new miracle drug. Everyone wants them. Drugs such as Ozempic, Wegovy, and Trulicity are in such short supply they are currently very difficult to find in pharmacies. Daily articles are in the press. The cost of these drugs is high, but insurance plans seem to be paying for them.
Not only are patients pressuring for access to these drugs, groups like the American College of Physicians, utilizing the power of their nationwide CME conferences and Medical Knowledge Self Assessment Program (MKSAP) are urging doctors to start them without delay. Specialists in other fields, such as Cardiology, Nephrology, and Vascular medicine are urging their patients to call their PCP and get on these drugs now!
Since we are becoming a nation of obese prediabetics, it seems logical every one of us will soon be on these weekly injectables.
However…. It feels like deja vu all over again.
Even now, we’re hearing about the bad side-effects of these drugs: “Ozempic Face,” severe nausea and vomiting, belly pain, dehydration, etc. Yet, so far, these problems are still relatively minor. Certainly, nothing to panic about.
However, just remember: There is never a free ride in the world of medical treatment.
So true. With any new meds, we need to proceed with caution. I remember when Cipro and Levaquin came out and were being given out like candy for UTI’s and pneumonia, even though there were older meds that worked perfectly fine. Funny how the next best thing can turn out to be the next worst thing.
It’s honestly depressing. Steven, your excellent examples highlight decades of flim-flam and bad faith. Especially given the experience of the last three years, who could ever trust pharmaceutical companies, or government regulators, or competing corporate interests, or lawyers (well obviously we can trust them to always target someone to make a $), or … patients? From what I observe, most patients don’t want to get “better”, they just want another pill or shot for every complaint, and it better damn work.
All of this furthers my evolved belief that there should be NO prescription required for ANYTHING, we should all get on the Mexican standard. You want weight loss shots, the local CVS know-nothings can shoot you up. You want pain or anxiety meds to numb up the rest of your days, hit the Walgreens and tell them it is your right. Physicians should be paid consultants, with NO liability for the actually helpful meds, or semi-snake oil being pushed now, and let the buyer beware. It turned out to be a fatal mistake for this profession to attempt to protect patients-at-large from themselves, and we should quit.
The Law of Unintended Consequences. Medicine is replete with them. Follows the old maxim my professor said “New and approved is not necessarily New and Improved”