Physician Calls for National Dialogue on Inequitable Access to Lifesaving GLP-1 Medications

W. Timothy Garvey, MD, associate director of the department of nutrition sciences at the School of Health Professions at the University of Alabama Birmingham, discusses the challenges with access to effective new obesity medications like semaglutide and tirzepatide. While increased awareness of these therapies is beneficial, media portrayal has led to shortages as the medications are used by some who may not need them for health reasons. He urges a national dialogue to address inequities collaboratively without blame, ensuring obesity medications can be accessed like other lifesaving treatments.

Image Credit: zimmytws - stock.adobe.com

Q: GLP-1 medications have recently gained popularity due to reported use by celebrities. How might this media attention impact the perception and use of these medications for patients who need them for medical reasons beyond just weight loss?

W. Timothy Garvey: Well, I think this is a double edged sword in terms of the media presentation of the availability of these second generation, very effective medications for the disease of obesity. It increases awareness; it increases awareness of potential therapies that could really benefit patients health and improve their quality of life. At the same time, they're not really being kind of presented to people as therapies for a disease. It's more kind of cosmetically related weight loss. This leads to people kind of availing themselves of the medications that really don't need them, and we have shortages of these medications, so it just means there's less medicine to go around for patients that really do need them. I mean, it's not unusual for doctors to have patients on a given doses of semaglutide or tirzepatide. Now, when it comes time to increase to the next level of dosage, or to continue the next month's dosage, the medicines just aren't available, and then you're in a quandary as to how how you manage those patients [and] what they do about that. It's just not that ideal, and I think the way the media presents these medications and leads to kind of medicine getting in the hands of people that don't really need it, kind of accentuate that shortage. Now, there was a presentation of the Oscars. I think Jimmy Kimmel was the host, and he made a joke about Ozempic, and the whole audience laughed their heads off, which tells me that everybody that's attending the Oscars was on Ozempic, and I imagine a lot of the folks whose folks really didn't need it for health reasons, ao an just an example.

Q: What steps can be taken to ensure fair and equitable access to GLP-1 medications for patients who qualify for the indications, regardless of recent media hype?
W. Timothy Garvey: We really need a national dialogue along these lines. [It's not] that one segments fault. There's a number of pillars in society, if you will, with vested interests in obesity that need to play a role in this. I think, as a physician, this is just an untenable situation. These medicines are lifesaving. We know that from the SELECT study, and are we going to prevent patients access to lifesaving medications? So we do that with statins? So are we're going to take statins away for people or make it hard for people to get statins? And the same principle and right now, people that really can benefit from these medicines don't have access to them. Part of the reason is certainly cost, and then as the people that might need them the most perhaps more resource challenged individuals that can't get these medications are. It's not fair either, that I think the US is paying up to 15 times more than other westernized countries for this medication, and it's not just increased cost to the patient, our whole society has to sustain that increased cost. So all of these inequities, we really need to get serious about this and address this. I mean, again, lifesaving medications that patients can't access and that just shouldn't be an acceptable situation to anybody. I don't have the answers. I just know we need to talk about it and to work together. Not necessarily by blaming each other but just kind of working together in good faith to develop some solutions.