Sydney Lupkin

The federal government and the pharmaceuticals industry are about to go head-to-head once again. In its last full weekday in office, the Biden administration has named the next 15 drugs up for price negotiation in Medicare. Ozempic is on the list.

The federal government and the pharmaceuticals industry are about to go head-to-head once again. In its last full weekday in office, the Biden administration has named the next 15 drugs up for price negotiation in Medicare. Ozempic is on the list.

The type 2 diabetes blockbuster drug is joined by its obesity drug cousin, Wagovi, as well as drugs for various cancers, asthma, psoriasis, and bipolar disorder. The government can't pick just any drugs in Medicare. There are certain rules laid out in the Inflation Reduction Act that say which drugs are eligible. The negotiations will take place in the coming months. Sydney Lufkin, NPR News.

The type 2 diabetes blockbuster drug is joined by its obesity drug cousin, Wagovi, as well as drugs for various cancers, asthma, psoriasis, and bipolar disorder. The government can't pick just any drugs in Medicare. There are certain rules laid out in the Inflation Reduction Act that say which drugs are eligible. The negotiations will take place in the coming months. Sydney Lufkin, NPR News.

Yeah, it is super, super different.

And that's because weed on the federal level is illegal.

Pharmaceuticals, on the other hand, have to be approved by the Food and Drug Administration based on a very detailed process involving clinical trials and inspections to verify safety and efficacy.

With weed, that robust federal system is not there, which means that the states are basically having to figure this all out on their own and stand up their own

many FDAs and many EPAs.

And they do have a group that they have sort of formed together called CANRA, which is basically a way for state regulators to communicate from state to state with one another to share data and what's working and what's not working.

But that has its limitations because the standards are still kind of a patchwork.

Yeah, so state officials had been doing this like across several different state agencies.

But a few years ago, they consolidated into the DCC, which is their Department of Cannabis Control.

And they're basically tracking almost every step in the cannabis pipeline.

Like every plant has a tag and an ID and it gets logged into a database.

Like weed manufacturers even have to report how many pounds of like plant trimmings they throw away.

Wow.

The labs have sort of had to keep up with this like really interesting and like creative industry where like, you know, one day they're like, oh, well, now we've got THC popcorn on the shelves.

Like, how do you test that?

Right.

And they've got to figure it out.

And that isn't to say that DCC is like doing everything perfectly because –

It's not.

There was some reporting by the LA Times that there were still pesticides in the legal weed products, particularly in the vapes.

So the department is, you know, evolving and trying to respond to that.

And it's definitely upped its testing and enforcement in the last few years.

So in 2024, there were over 60 weed recalls.

And then this year, they've already had 80 weed recalls.

And it's only October.

Yeah.

And they've taken 10 actions against laboratories so far this year.

Yeah, so he said that there were over 600 contaminants that were regulated across the 30 states that had legalized cannabis at that time.

But in each state, there were only between 60 and 120 contaminants that were being regulated.

So in other words, different states were looking for different contaminants.

I also asked Lung, you know, whether states testing for just more contaminants maybe had safer weed.

And he said no.

Wow.

It's not really well studied.

So a state that might be testing for 300 things might not be testing for the one thing that is guaranteed to give you cancer someday.

And a state only testing for a few contaminants might in fact be testing for that very bad thing.

But without that research, which is hard because weed is still federally illegal, it's really hard to know what the worst contaminants are.

Yeah, I definitely want to echo that.

I talked to a weed cultivator who went from the illegal market to the legal one, and he described it as this sort of wild, wild west.

And this guy was like, yeah, there used to be just a guy in a room spraying pesticides with the door closed and no protective gear.

And that just doesn't fly in the legal market.

So if you care about the people who are growing your weed...

It's nice to go legal.

And then just if you're trying to be safer for you, it's a good idea to familiarize yourself with what your state regulations are and to regularly check recall lists, which are often published online.

I think that that would be a good idea.

Thank you.

Thank you.

Yeah, hi, Scott.

Yeah, hi, Scott.

Yeah, hi, Scott.

Yeah. And in most circumstances, it would be celebrated all around. But in this case, many people will end up spending more to manage their obesity. Here's what's happening. Terzepatide is the active ingredient in Eli Lilly's Zepbound for Obesity and Manjaro for Diabetes.

Yeah. And in most circumstances, it would be celebrated all around. But in this case, many people will end up spending more to manage their obesity. Here's what's happening. Terzepatide is the active ingredient in Eli Lilly's Zepbound for Obesity and Manjaro for Diabetes.

Yeah. And in most circumstances, it would be celebrated all around. But in this case, many people will end up spending more to manage their obesity. Here's what's happening. Terzepatide is the active ingredient in Eli Lilly's Zepbound for Obesity and Manjaro for Diabetes.

Specialized pharmacies called compounding pharmacies have been legally allowed to make what are essentially copies of terzepatide Because the brand name drugs were in shortage. And the compounded versions of the medicines were a lot cheaper. A few hundred dollars a month for patients compared with $1,000 or more for the brand name drugs.

Specialized pharmacies called compounding pharmacies have been legally allowed to make what are essentially copies of terzepatide Because the brand name drugs were in shortage. And the compounded versions of the medicines were a lot cheaper. A few hundred dollars a month for patients compared with $1,000 or more for the brand name drugs.

Specialized pharmacies called compounding pharmacies have been legally allowed to make what are essentially copies of terzepatide Because the brand name drugs were in shortage. And the compounded versions of the medicines were a lot cheaper. A few hundred dollars a month for patients compared with $1,000 or more for the brand name drugs.

Yeah, so the stakes are high. In October, FDA first said the shortage was over, but a trade group for the largest compounding pharmacies sued the FDA, challenging that determination. The compounders said there was no way the shortage could be over because many patients still couldn't fill their name-brand prescriptions

Yeah, so the stakes are high. In October, FDA first said the shortage was over, but a trade group for the largest compounding pharmacies sued the FDA, challenging that determination. The compounders said there was no way the shortage could be over because many patients still couldn't fill their name-brand prescriptions

Yeah, so the stakes are high. In October, FDA first said the shortage was over, but a trade group for the largest compounding pharmacies sued the FDA, challenging that determination. The compounders said there was no way the shortage could be over because many patients still couldn't fill their name-brand prescriptions

And they allege that the FDA hadn't determined how many people would need to make the switch from the compounded to the name brand drugs either. So the FDA took another look and for a second time declared the triseptide shortage resolved.

And they allege that the FDA hadn't determined how many people would need to make the switch from the compounded to the name brand drugs either. So the FDA took another look and for a second time declared the triseptide shortage resolved.

And they allege that the FDA hadn't determined how many people would need to make the switch from the compounded to the name brand drugs either. So the FDA took another look and for a second time declared the triseptide shortage resolved.

The agency says it took a look at many factors, including the drug manufacturer's inventory data, projected demand. It says it also spoke to patients, healthcare providers, and compounding pharmacies. Bottom line, the agency said it thinks Eli Lilly can make enough. Lilly said in a statement that the FDA decision reflects the company's hard work to expand its manufacturing capacity.

The agency says it took a look at many factors, including the drug manufacturer's inventory data, projected demand. It says it also spoke to patients, healthcare providers, and compounding pharmacies. Bottom line, the agency said it thinks Eli Lilly can make enough. Lilly said in a statement that the FDA decision reflects the company's hard work to expand its manufacturing capacity.

The agency says it took a look at many factors, including the drug manufacturer's inventory data, projected demand. It says it also spoke to patients, healthcare providers, and compounding pharmacies. Bottom line, the agency said it thinks Eli Lilly can make enough. Lilly said in a statement that the FDA decision reflects the company's hard work to expand its manufacturing capacity.

and meet patient needs. So compounding pharmacies will need to stop making and selling the compounded versions in February or March, depending on their size.

and meet patient needs. So compounding pharmacies will need to stop making and selling the compounded versions in February or March, depending on their size.

and meet patient needs. So compounding pharmacies will need to stop making and selling the compounded versions in February or March, depending on their size.

Yes, though the exact number is hard to pin down. I've heard from lots of patients who consider them a lifeline, and that's because many health insurers won't cover the drugs for weight loss. Medicare, for instance, is banned from covering drugs for weight loss because of an old law written at a time when having obesity was considered more of a personal failure than a health condition.

Yes, though the exact number is hard to pin down. I've heard from lots of patients who consider them a lifeline, and that's because many health insurers won't cover the drugs for weight loss. Medicare, for instance, is banned from covering drugs for weight loss because of an old law written at a time when having obesity was considered more of a personal failure than a health condition.

Yes, though the exact number is hard to pin down. I've heard from lots of patients who consider them a lifeline, and that's because many health insurers won't cover the drugs for weight loss. Medicare, for instance, is banned from covering drugs for weight loss because of an old law written at a time when having obesity was considered more of a personal failure than a health condition.

That means people without coverage will have to pay the full sticker price for the name brand drugs, and that's unaffordable for a lot of people who've turned to the cheaper compounded versions of the drugs.

That means people without coverage will have to pay the full sticker price for the name brand drugs, and that's unaffordable for a lot of people who've turned to the cheaper compounded versions of the drugs.

That means people without coverage will have to pay the full sticker price for the name brand drugs, and that's unaffordable for a lot of people who've turned to the cheaper compounded versions of the drugs.

Some are stockpiling the compounded drugs, you know, while they can. I checked in with Mary Struski, an Arizona woman who told me a few weeks ago about how she lost 50 pounds so far on compounded terzepatide. She says she and her nurse practitioner settled on a plan to buy enough terzepatide to get her through until about April.

Some are stockpiling the compounded drugs, you know, while they can. I checked in with Mary Struski, an Arizona woman who told me a few weeks ago about how she lost 50 pounds so far on compounded terzepatide. She says she and her nurse practitioner settled on a plan to buy enough terzepatide to get her through until about April.

Some are stockpiling the compounded drugs, you know, while they can. I checked in with Mary Struski, an Arizona woman who told me a few weeks ago about how she lost 50 pounds so far on compounded terzepatide. She says she and her nurse practitioner settled on a plan to buy enough terzepatide to get her through until about April.

And after that, she isn't sure, but she says she needs to find a way to keep taking the medicine.

And after that, she isn't sure, but she says she needs to find a way to keep taking the medicine.

And after that, she isn't sure, but she says she needs to find a way to keep taking the medicine.

Her health is better, and she says she's free of the anxiety that came with eating. She's thinking about what she wants to accomplish in 2025.

Her health is better, and she says she's free of the anxiety that came with eating. She's thinking about what she wants to accomplish in 2025.

Her health is better, and she says she's free of the anxiety that came with eating. She's thinking about what she wants to accomplish in 2025.

You know, it could because the FDA just approved ZepBound as the first drug treatment for moderate to severe obstructive sleep apnea in patients who have obesity. Obstructive sleep apnea is a condition in which someone temporarily pauses breathing in their sleep because their upper airway collapses. It is more common among people who have obesity.

You know, it could because the FDA just approved ZepBound as the first drug treatment for moderate to severe obstructive sleep apnea in patients who have obesity. Obstructive sleep apnea is a condition in which someone temporarily pauses breathing in their sleep because their upper airway collapses. It is more common among people who have obesity.

You know, it could because the FDA just approved ZepBound as the first drug treatment for moderate to severe obstructive sleep apnea in patients who have obesity. Obstructive sleep apnea is a condition in which someone temporarily pauses breathing in their sleep because their upper airway collapses. It is more common among people who have obesity.

The new approval could open the door for ZEP-bound coverage by Medicare and Medicaid because it's not just a weight loss drug anymore. So while that's not going to solve everyone's insurance problems here, it could help a lot of people.

The new approval could open the door for ZEP-bound coverage by Medicare and Medicaid because it's not just a weight loss drug anymore. So while that's not going to solve everyone's insurance problems here, it could help a lot of people.

The new approval could open the door for ZEP-bound coverage by Medicare and Medicaid because it's not just a weight loss drug anymore. So while that's not going to solve everyone's insurance problems here, it could help a lot of people.

You bet.

You bet.

You bet.