Semaglutide 2.4 mg – New Weight Loss Medication Preview…

Posted: Feb 14 in Weight Loss Medication by Dr. Lazarus

Just published in the New England Journal, as part of a weight loss program, the addition of semaglutide helped people with obesity lose an average of 15% of their body weight during 68 weeks of treatment.

This equated to an average of 34 pounds of weight loss during the trial.

Heart Safety of Semaglutide

As one would hope with this dramatic weight loss, semaglutide also improved cardiovascular risk factors including blood pressure, blood sugar and cholesterol levels, body mass index, waist circumference as well as physical functioning scores and quality of life. In their diabetes studies, semaglutide showed a marked reduction in risk for major adverse cardiovascular events like heart attack and stroke.

How is semaglutide 2.4 mg different from Ozempic?

Semaglutide has already been in use for several years under the brand name Ozempic for the treatment of type 2 diabetes. The difference between this and Ozempic is in the dose – the diabetes version is 0.5 or 1.0 mg injected weekly. This new version is 2.4 mg injected weekly. At these higher doses, the semaglutide provides superior weight loss, as demonstrated by this phase III study.

How does semaglutide 2.4 mg compare to other weight loss medications?

Compared to the other currently available weight loss medications, the semaglutide provides significantly greater weight loss. Medications like phentermine, Tenuate (diethylpropion), Contrave, Qsymia and Saxenda double to triple the odds of losing and sustaining a 5-10% weight loss. With an average weight loss of 15%, this suggests that the 2.4 mg dose of semaglutide is at least 50% stronger than currently available medications. Further, unlike the currently available medications that require daily dosing, the semaglutide offers the convenience of once weekly dosing, albeit as a self-administered injection.

Side effects of semaglutide for weight loss

Side effects are similar to other GLP-1 analogue medications like Victoza, Ozempic and Saxenda, and are primarily gastrointestinal in nature (nausea, vomiting, constipation, diarrhea, etc.) These are generally mild, and usually resolve over time. Again, like other GLP-1 analogues, semaglutide should not be used in people with a personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasia type 1, or with a history of pancreatitis. We will need to wait and see how the final labeling looks for full information.

When will this be approved for weight loss?

Based on these results, Novo Nordisk has applied with the FDA to have the 2.4 mg semaglutide dose approved for chronic weight management. They are hopeful to see their new weight loss medication (anti-obesity medication) approved this year, hopefully this Fall.

How much will it cost?

Like Saxenda and Ozempic, the 2.4 mg semaglutide will likely be quite expensive when released (? $1,000 / month). Currently, many employers offer coverage for these anti-obesity medications. We have seen good coverage for hospital employees (Health One, Children’s), technology companies (Lockhead Martin, Aerospace), oil and gas companies, financials (Fidelity) and others. People with insurance coverage often pay as little as $25 per month for the currently available Saxenda. Now is the time to ask your employer to add coverage for anti-obesity medications if you’d like to benefit from the latest science, research, heart safety and weight loss these new treatments can offer.

Note that for those without coverage, Saxenda currently costs around $1,000 per month, although sometimes Dr. Lazarus can help you find far more cost-effective sources… Further, note that it is the employer, not the insurer who determines coverage. Finally, note that Medicare currently continues to refuse coverage for any weight loss medication due to out of date restrictions. Encourage your congress person to support the Treat and Reduce Obesity Act which would eliminate this old language and allow proper coverage determinations.

Stay tuned to the CNC newsletter for more up-to-date information when semaglutide 2.4 mg weekly (name T.B.D.) becomes available!