Ozempic has taken the pharmaceutical world by storm in the last year. The semaglutide injection is approved to treat Type 2 diabetes, but its off-label use as a chronic weight-loss drug has introduced Ozempic to a new wave of patients who are seeking modern alternatives for weight management. However, it comes as no surprise that Hollywood's favorite miracle drug costs a shiny penny—making the GLP-1 medication financially inaccessible for most Americans.
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The telehealth company Ro estimates that Ozempic patients without insurance coverage are spending around $935.77 per month. While there are GoodRx coupons and savings programs that can help lower the cost, it doesn’t take away from the fact that many qualified patients simply can’t afford to cough up thousands of dollars for one medication.
For some patients, Ozempic’s hefty price tag has deterred their progress. One study found that Ozempic users regain two-thirds of their weight loss within a year of going off the medication.
The conundrum has forced many obesity medicine doctors, like Sarah Ro, MD, to research and devise drug alternatives that are still effective for weight loss but don’t break the bank.
In an interview with The Atlantic, Ro explained how she’s helped hundreds of patients switch to lesser-known yet more affordable non-GLP-1 medications, whose off-label use for weight loss has a proven track record.
Ro, who also serves as the director of the University of North Carolina Physicians Network Weight Management Program, is prescribing older drugs like topiramate, phentermine, metformin, bupropion, and naltrexone instead of Ozempic for her weight loss patients. While they aren’t as fast-acting as semaglutide injections, they are significantly cheaper and don't require an injection (they can all be taken orally). Under a generic brand, one month’s supply costs about $10, Ro Says.
However, similar to Ozempic, these drugs help treat other medical issues and, therefore, come with their own list of possible side effects and health risks.
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For instance, metformin is a prescribed tablet used to treat Type 2 diabetes by helping "restore the way you use food to make energy,” explains Mayo Clinic. Some of the most common side effects include decreased appetite and weight loss. Like Ozempic, metformin patients may experience bloating, stomach pain, heartburn, and diarrhea.
Topiramate is used to manage and treat epilepsy and migraines. However, it’s also been approved for chronic weight management in patients whose body mass index exceeds 30. Speaking with The Atlantic, Jamy Ard, MD, an obesity-medicine doctor at Wake Forest University School of Medicine, explained that topiramate can be particularly beneficial for soda lovers as it affects the taste of carbonated drinks.
Bupropion is used to prevent depression and treat seasonal affective disorder (SAD). It may also be prescribed to people who want to quit smoking, similar to naltrexone, which “works by blocking the effects of narcotics, especially the ‘high’ feeling that makes you want to use them,” says Mayo Clinic. The combination of bupropion and naltrexone can help those who struggle with emotional eating by making food “less pleasurable,” according to Ard.
Phentermine, however, is specifically prescribed for weight loss. It attacks the appetite, either making you less hungry or feel full longer. “Phentermine is for people with obesity or overweight who haven't been able to lose enough weight with diet and exercise alone to improve their health,” explains Mayo Clinic.
Coupled with healthy lifestyle changes like diet and exercise, Ro said patients can still achieve weight loss—albeit more slowly—with these cheaper alternatives if Ozempic isn’t for them.
Of course, people should always speak with their healthcare provider before going on any new medication, as side effects and adverse health risks can vary from patient to patient.
Best Life offers the most up-to-date information from top experts, new research, and health agencies, but our content is not meant to be a substitute for professional guidance. When it comes to the medication you're taking or any other health questions you have, always consult your healthcare provider directly.
