This Is What a Miracle Drug Looks Like. And It Only Costs $5 to Make

NY Times science writer David Wallace-Wells believes that the eventual $1 Trillion per year cost of weight loss drugs like Ozempic and Zepbound, will force a reckoning on US drug pricing.

For the past 30 years, I’ve kept about half of my retirement portfolio in drug stocks. I originally bought them for the R&D, but I stayed for the bipartisan political corruption and the fact that racism, ignorance and innumeracy informs so much of our public policy. It’s been a very profitable ride.

I see nothing in the current culture that will change this.

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{{ A month of doses can be manufactured for less than $5, which means that American customers are paying a 200-fold markup or more, with many of them paying it out of pocket. That suggests one additional way that semaglutide could reshape American health and health care: The price of marginal production has never determined American medication costs… }}



…with the exception of our favorite illegal drugs, which likely have far more efficient and less rapacious pricing, even accounting for the costs of bribes, smuggling, and arrests of underlings.

Truly evil and appalling and staggeringly stupid.

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(and one of the many reasons I live in Mexico, paying all of my medical costs out of pocket, albeit with Medicare as my insurance of something goes monstrously wrong)


I discovered a fly in the ointment. My grandmother would love that liberal use of my tongue.

Grandma was an Irish immigrant to America at age 76. She had private insurance in Ireland. The insurance had a reciprocal agreement with Blue Cross Blue Shield. That was the only way she could get insurance to live in the US. She had not paid in for Medicare.

One of the best things she ever did was move to the US. The family dynamics and her well being physically and emotionally were lifted. She lived till 98 years of age. Several of her grandchildren were in their 40s by then. We miss her.


Which is, of course, expensive and unpredictable. Thus the manufacturing cost of $5 has little relation to total costs. Similarly, what does it cost to manufacture ‘software as a service’?



I was sure we’d had a thread on this topic…but I’ve come across iterations of the story on so many other sites, I’m probably confused.

One particular site (non financial) had all the usual blather…and, since the site seems to attract folk from overseas…multiple examples of the much lower cost in places such as Australia, Bulgaria, Norway. All places with universal access to medical care, a third party payor system (but not necessarily fully taxpayer funded) and some scheme whereby there’s a degree of government negotiation and control over pricing…which the US doesn’t have.

For all that the general opinions seemed to be that this was an outrageous state of affairs, when I pointed out that overseas governments are helped a bit in their ability to strong-arm these price cuts by the fact that the pharma companies can transfer any shortfalls in desired profits to the US market, and then asked how much extra these lucky individuals would be prepared to pay to give us poor sods a break, no one answered. So I guess the notion that, one person’s Good Deal is another’s rip-off doesn’t hold water when the person with the Good Deal can make a decision :thinking:


Another thing I wonder is, where does this “cost of manufacture” come from?. Originally, that is…not the multiple iterations of the story that are presumably derived from some press release or other? Did someone sit down a try to source the costs of raw materials, delivery systems, packaging etc and add that up? Does it include the cost of employee compensation packages for the workforce involved in said manufacture (pretty sure Novo Nordisk doesn’t employ volunteers)? Note, I’m not mentioning the cost of R&D here…just the tangibles that go into everything else we use on a daily basis (and have given us the ability to purchase said stuff)


Pharma pricing segmentation has some similarity to airline pricing. Rather than have one set price to go from A to B, airlines have higher prices for the market segments that can afford it (think business travelers) ‘regular’ and discounted fares. The US market is the equivalent of business or first class.


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In reality, I think it’s a bit more complicated than that but still, when any of my UK cronies are gobsmacked at the cost of my meds (that are disappointingly necessary even after a life of Good Custodianship of my body…no Ozempic for moi). That’s my co pay alone, mind, and not the cost of Medicare Part B premiums and Part D (they all imagine that Medicare is like the NHS and FREE!!!) I usually reply “You’re welcome”.


There was a piece on the evening news last night, about a state that will no longer cover, iirc Ozempic, for it’s employees, for weight loss. A state official noted how much of the state’s medical care budget was being consumed by that one treatment. He also pointed out that a dose that costs $1000 in the US, only costs $300 in the manufacturer’s home country.



That is hilarious. State works on a diet pill. State does not want to spend the money.

So just sit there gaining weight?

What could go wrong?

The unfortunate fact is that obesity costs an extra $6,000 in annual medical expenses so if the drug costs twice that figure, it is more economical for both the insurance companies and the federal government (Medicare/aid) that the drug not be covered - or at least not covered without some significant cost sharing.

Cheaper to treat the symptoms of obesity than it is to cure it with a drug that requires lifetime use.


Well the calculations might be skewed a bit by the fact that one of the symptoms of obesity is frequently a shortened life span as well as health span. Not covering these meds might well be more cost effective if “coverage for life” is a longer life.

Exactly! In an environment where we need fewer workers, the wealthy who have bought and paid for our political leaders don’t see an ROI on keeping an excess of people around. We don’t even need them for cannon fodder anymore – drones are doing a lot of the fighting.


Obese people are not PQ, so not even useful as cannon fodder.


Depends if the pseudo-JCs can obtain more profit from them than the cost (not the selling price) of the drug(s).

We spend a lot of time in this country blaming cabals and conspiracies for all are problems. Simple fact is that if the great majority of those who want cheap meds would vote for candidates that support social programs that would lower the cost of meds, it would happen. They don’t.

The majority of Americans don’t want big government. The majority of Americans don’t want socialism. The majority of Americans who complain that medical care and drugs are too expensive won’t vote for politicians who would do something about it. It is weird, it makes no sense, but it is reality.


Nice try, but not quite.

Individual states have tried. But individual states can not succeed in any plan because all the other states would send their sick residents to that state and thus make it non-viable. Only a national program can succeed because then there is no place for states to send sick residents and avoid the cost of taking care of them.

Of course, the states that refuse universal health care are the ones with the vast majority of low population density. The only locations in those states with high density residents tend to be in favor of universal health care. Those cities don’t really have a significant say in governance of their states. And I do not expect that to change.


What’s really funny is what’s happening in Texas with all the rural hospitals closing. Lack of the Obamacare Medicaid expansion, plus rural folks’ preference for Medicare Advantage which reimburses hospitals at a much lower rate than that “Big Gov’t” traditional Medicare is to blame for the lack of hospital revenue.

Of course, the voters think it’s immigrants and “the woke” {{ LOL }}

I imagine that the lower life expectancy for older folks who reside some distance from a hospital will solve this problem over time.