Eli Lilly to sell Zepbound directly to consumers without insurance coverage
An Eli Lilly & Co. Zepbound injection pen arranged in the Brooklyn borough of New York, US, on Thursday, March 28, 2024. (Shelby Knowles/Bloomberg via Getty Images)
(NEW YORK) — People who are in need of weight loss medications but do not have insurance coverage will soon have a new way to access one of the popular medications, Zepbound.
Eli Lilly, the maker of Zepbound, announced Tuesday it will begin selling the weight loss drug directly to consumers through the company’s direct pharmacy, LillyDirect.
With a doctors’ prescription, consumers will be able to purchase Zepbound in vial forms that are about half the price of the auto-injector pre-filled pens sold in pharmacies, according to Eli Lilly CEO Dave Ricks.
A one-month supply of Zepbound at a 2.5-milligram dose will cost $349, while a one-month supply at a 5-milligram dose will cost $549, according to Ricks.
Medical professionals can start filling prescriptions for the Zepbound vials on Tuesday via LillyDirect and the vials will start shipping in the days ahead.
Ricks noted that the new option will be self-pay only and will not participate in insurance.
With insurance coverage, Zepbound can cost as low as $25 per month, but without coverage, the medication can cost more than $1,000 per month.
Consumers who purchase Zepbound through LillyDirect will have access to educational resources on how to administer the medication, according to Ricks.
Zepbound is approved by the U.S. Food and Drug Administration as a weight loss management treatment for people with obesity or those who are overweight with at least one related underlying condition such as high blood pressure.
However, many private insurers and Medicare do not cover weight loss drugs used for obesity.
Zepbound contains the same active ingredient, tirzepatide, as another medication, Mounjaro, which is also made by Lilly and is FDA-approved to treat Type 2 diabetes.
Tirzepatide works by helping the pancreas increase the production of insulin to move sugar from the blood into body tissues.
It also slows down the movement of food through the stomach and curbs appetite, thereby causing weight loss.
Past clinical studies have shown users of medications used for weight loss like Zepbound and Mounjaro can lose between 5% and 20% of their body weight on the medications over time.
Medical specialists point out that using medication to lose weight also requires cardio and strength training and changing your diet to one that includes proteins and less processed foods with added sugars.
The most commonly reported side effects of medications used for weight loss are nausea and constipation, but gallbladder and pancreatic disease are also reported.
Makers of these drugs recommend having a conversation about the side effect profile and personalized risks with a health care professional before starting.
Sara Anne Willette and her family plan on moving to the countryside in the South as COVID-19 continues to impact the immunocompromised community. — Courtesy of Sara Anne Willette
(NEW YORK) — Sara Anne Willette has spent more than 1,620 days in isolation since the start of the COVID-19 pandemic.
The New Jersey resident took health precautions in public before the pandemic because of her common variable immunodeficiency, which means she doesn’t make enough antibodies to fight infections.
Simple tasks like going for a walk down the street or taking a trip to the grocery store are laden with safety hurdles and anxiety for Willette.
Stressful tasks, like moving from Iowa to New Jersey during the pandemic for her husband’s new job, are now even more taxing. The two drove overnight to avoid crowds at gas stations and rest stops, and she’s prepared to do it again. The substantial health precautions in her day-to-day life are forcing her and her family to pack up their life once more and look for a new home in the countryside.
“I’m angry that society is largely inaccessible and I have to risk my life for the bare minimum, like medical care,” Willette told ABC News in a phone call. “Why live in civilization if all of it is completely inaccessible?”
More than four years after the start of the COVID-19 pandemic, Willette is among the immunocompromised and disabled Americans who’ve complete changed their way of living to survive.
Her anger was tinged with disappointment as she talked about how the rest of the world has gone back to normal despite the hundreds of people across the country dying from COVID-19 each week amid a summer surge of the virus.
COVID-19 has also been a debilitating event for tens of millions of people who have or are currently experiencing long COVID, which in some cases has been defined as a disability under the Americans with Disabilities Act.
With some lawmakers beginning to propose mask bans in hopes of reducing crime, it’s no longer an option for some to live life normally among the rest of society.
Willette was among the people ABC News checked back in with after previously talking to them about isolating two years after the pandemic began.
Finding a new normal
There are simple joys that Willette misses: having a garden, running, walking, letting her dogs run without a leash and drinking coffee on a porch.
She’s planning on moving to the mountains — somewhere between New Hampshire and Virginia — and gaining enough acreage to allow her and her family to embrace the activities they lost during the pandemic. However, being alone out in the countryside isn’t the goal for Willette.
Rather, she intends to build a pathogen-aware community. That means buying enough land so other disabled, immunocompromised or health-conscious able-bodied people who don’t want to get COVID-19 can join them and create a home of their own.
“We want something that feels like normal but is set up in a way that we decrease harm for everyone in the community,” Willette said. “We can’t do that in an urban area or even in a suburban area. There are too many risks.”
Her mother and mother-in-law intend to move and join Willette, her husband and her son on the property as well.
For Charis Hill, a California resident who has a systemic inflammatory disease and takes immunosuppressive medications, it’s been hard to access an in-person doctor’s appointment since many safety precautions for COVID-19 are no longer being taken in medical care facilities.
As someone with “high-level medical needs,” the lack of COVID precautions has even made seeking routine care a challenge.
“Just the fact that a medical environment that is supposed to know what a virus can do, most medical environments no longer require masking, and that’s what makes it unsafe for people like me to go, for anybody to go,” Hill told ABC over the phone.
“The impact of the delayed care, where people can’t go get routine care, that’s going to affect the whole health care system. Emergencies happen because of delayed care.”
Despite the stress and forced isolation, they find moments of joy growing their own food in their garden, and stay busy by working to reduce the local feral cat population through Trap-Neuter-Return practices.
They break their isolation monthly to meet at a park with a close-knit circle of friends who take similar safety precautions — they’re all masked, socially distanced and have tested beforehand.
“That’s really the only way for me to meet strangers and also to make new friends,” Hill said.
Mask bans would further bar immunocompromised people from public life, according to Hill.
Such bans “make it unsafe for us to exist,” Hill noted, because people may feel pressure not to wear masks when they’re sick or if immunocompromised people are worried about backlash for doing so.
With more people testing positive for COVID this summer, and with the fall and winter virus season ahead, Hill says society’s “new normal” should involve free testing, vaccines, access to at-home antiviral therapy paxlovid and flexible hybrid working options to mitigate the spread of illnesses.
“We need a new normal, and a new normal that is equitable for everyone, and that not only prioritizes high risk people, but that also reduces infection overall,” Hill said.
COVID concerns for the immunocompromised population
Immunocompromised people — about 3% of the adult population in the U.S., according to the National Institutes of Health — continue to face potentially serious medical complications or death when it comes to COVID-19. Even for those who were not previously at risk now have seen life-changing heath impacts.
“Long COVID can happen to anyone, and I have certainly seen young, healthy, vigorous athletes have prolonged, debilitating symptoms from long COVID,” Dr. Jeannina Smith, the medical director of University of Wisconsin’s Transplant Infectious Disease Program, told ABC over the phone.
However, society has largely appeared to have moved on. The CDC stopped recording some COVID-19 related data and some politicians have proposed mask bans as a potential solution to crime.
“It takes us a step back for public health,” Hill said. “We have other pandemics that are coming, and it’s going to make it harder to reenact mask mandates if we need them in the future.”
For the immunocompromised, regular society could seem like a minefield, according to Dr. Cassandra M. Pierre, the medical director of Public Health Programs and the associate hospital epidemiologist at Boston Medical Center.
She noted that people at higher risk for complications “are still, unfortunately, in our hospitals today. We see that they have this forced risk of going on to develop critical COVID or potentially even die. This is still occurring. COVID is still happening.”
This is all happening despite a better understanding of disease transmission and the information needed to be better equipped to empower communities to protect their health, Pierre added.
Patients have been harassed or mocked for wearing masks in public, Dr. Jeannina Smith noted, despite international and national medical organizations emphasizing the importance of mask wearing as a mitigation tactic for illnesses. Hill has experienced this first hand.
“You can’t look at someone and know that they’re receiving immunosuppression for an organ transplant or an autoimmune condition, and they remain at risk,” Smith said.
“Even if you don’t have individual risk, any person can still spread COVID to someone who has higher risk,” she said. “In fact, much of the spread continues to be from asymptomatic person. The very idea that we would criminalize wanting to protect our fellow citizens is pretty horrific.”
The federal government has recently changed its tune amid the summer COVID spike and is preparing for the upcoming fall and winter season by approving and granting emergency use authorization for updated COVID-19 vaccines and restarting its free at-home COVID tests program.
(NEW YORK) — A new report by March of Dimes found that over 5.5 million women live in U.S. counties experiencing limited to no access to maternity care resources that include hospitals or birthing centers, obstetric care or obstetricians.
The report is the latest by the maternity care-centric nonprofit to highlight a worsening state of maternity care in the U.S., with a rise in closure of hospital obstetric units contributing to what the organization calls “a growing maternal and infant health crisis.”
March of Dimes estimated that more than 2.3 million women of reproductive age live in counties deemed to be maternity care deserts, with approximately 150,000 births in these counties. More than three million additional women live in counties with limited maternity care access.
“We’re going from bad to worse. We already have the worst maternal mortality rate of our industrial peer countries, and we know that access matters,” Dr. Amanda Williams, March of Dimes’ chief medical officer, told ABC News. “If we don’t have access, then we don’t even have a chance.”
Maternity care deserts have a significant impact on health outcomes for expecting women. Data shows that women in maternity care deserts have a 13% chance of experiencing preterm birth, and receive inadequate prenatal care at higher rates, according to the report. Low-income and women of color are disproportionately affected.
People in maternity care deserts have to travel approximately 2.6 times further to receive care than those who live in counties where care exists, and early data has found that ob-gyns are leaving states with strictest abortion bans, Williams said.
“As the report suggests, the Dobbs decision — the effects of which have yet to be fully realized — is likely playing a major role in the already shrinking ob-gyn workforce in many rural areas of the country,” Dr. Stella Dantas, president of the American College of Obstetricians and Gynecologists, said in a statement.
“As we continue to find ways to increase access, we must also vigorously combat legislative interference in the practice of medicine so that clinicians are free to practice without fear of criminalization and patients are able to get the care they need and deserve in the communities they live and raise their families in,” the statement continued.
Approximately 35% of all U.S. counties are now considered maternity care deserts, having no birthing facilities or obstetricians. North Dakota, South Dakota, Alaska, Oklahoma and Nebraska are the most impacted states, according to March of Dimes.
Since 2022, over 100 counties experienced a decline in maternity care access, totaling over 100 hospitals closing their obstetric units, resulting in delayed access to emergency care and forcing families to travel farther to receive critical care, according to the report.
Between 2015 and 2022, the prevalence of pre-pregnancy hypertension rose by over 80%, according to March of Dimes. Preeclampsia, a potentially fatal condition that causes a pregnant woman’s blood pressure to rise, can lead to preterm birth, stroke, seizure, and other complications for expecting women.
In maternity care deserts, the rates of pre-pregnancy hypertension was 1.3 times higher than counties with full access to care, according to the report.
Leveraging telehealth services, improving reimbursement policies for obstetric services at hospitals, and improving access to midwifery services are some of the policy solutions to improve care, Williams noted.
“Not only are there people, a lot of people who live in these maternity care deserts, there are beautiful things, just as in the natural desert, you might find a gorgeous flower or cactus,” Dr. Williams said. “There are churches, there are community centers, there are community based organizations. And so we need to figure out how in healthcare and in public health, we can partner with some of those organizations to be able to extend care to those who live in maternity care deserts.”
(NEW YORK) — Nicole Hallingstad credits her cat, Rudy, with finding her breast cancer.
Despite an unremarkable mammogram screening just seven months earlier, the 42-year-old knew something was wrong when Rudy kept pawing at something on the right side of her chest.
Hallingstad had another mammogram, which this time found a golf-ball-sized tumor in her breast that she said was from a fast-growing form of breast cancer.
After surgery, she needed both radiation and chemotherapy – but neither were available where she lived.
Hallingstad faced a difficult decision. Her options were to travel more than 1,000 miles once a month for chemotherapy and then relocate for six weeks of radiation treatment, or move to another state where she could get chemotherapy and radiation in one place. Hallingstad chose the latter.
“I was very fortunate that I was able to take the option to move and continue working and receive the care I needed,” Hallingstad told ABC News. “But that is a choice that is unsustainable for far too many Native women, and frankly, uncertain.”
Why was cancer care so inaccessible for Hallingstad? Because she lived in Alaska.
Hallingstad, a member of the Tlingit and Haida Native Indian Tribes of Alaska, faced profound barriers to breast cancer care that are shared by many American Indian and Alaska Native (AI/AN) women. These barriers have contributed to growing disparities over the last three decades.
“It’s often really difficult to get to a qualified health care center that is close to the rural areas where so many of our people live,” Hallingstad said. “And transportation is not readily available for many people to get the trip to the center, to get their screening to even have access to the kind of machinery that is needed for this important treatment work.”
A recent report by the American Cancer Society (ACS) showed that the rate of breast cancer deaths among U.S. women has decreased by 44% from 1989 to 2022. But that progress has not held true for all women, including AI/AN women, whose death rates have remained unchanged during that same time.
While AI/AN women have a 10% lower incidence of breast cancer than white women, they have a 6% higher mortality rate, according to the ACS.
The ACS also found that only about half of AI/AN women over 40 years old surveyed for the report said they’d had a mammogram in the last two years, compared to 68% of white women. That lack of timely screenings increased the risk of discovering cancer in more advanced stages, which in turn could result in higher death rates.
“This is a population for which we are very concerned,” Karen Knudsen, CEO of the American Cancer Society, told ABC News. “Given the mammography rates [of AI/AN women] that we’re actually seeing, which are well behind other women across the country.
Knudsen emphasized the need to “create that additional awareness about the importance of getting screened for breast cancer early because of the link to improved outcomes,” especially in Indigenous communities.
There are also cultural barriers to cancer care and awareness. “Culturally, we don’t often speak about very deep illness, because we don’t want to give it life,” Hallingstad said.
That fear, not necessarily shared by all Indigenous communities, is a common reason people from any background may choose not to discuss cancer risk, or to seek help if they think they have a serious health problem.
Melissa Buffalo, an enrolled member of the Meskwaki Nation of Iowa, is the CEO of the American Indian Cancer Foundation, where she works alongside Hallingstad. Her organization recently received a grant to study the knowledge and beliefs surrounding cancer and clinical trials among Indigenous people in Minnesota. Buffalo said she hopes to “create resources and tools that are culturally relevant, culturally tailored, so that we can help to build trust within these healthcare systems.”
Advocates like Buffalo and organizations like the ACS are also creating toolkits to help existing systems increase their outreach to AI/AN women. However, “there is not a ‘one size fits all’ approach to everything,” Dr. Melissa Simon, an OB/GYN at Northwestern University and founder of the Chicago Cancer Health Equity Collaborative, told ABC News.
“We have to also acknowledge that the patient has some variation too, just like the cancer itself. To treat it has some variation,” Simon said.
“We have to talk about it,” Hallingstad said about breast cancer in the Indigenous community. “We need to understand treatment options. We need to bring care facilities closer and we need to make sure our populations are being screened and are following treatment.”
Jade A. Cobern, MD, MPH is a physician board-certified in pediatrics and preventive medicine and a medical fellow of the ABC News Medical Unit.
Sejal Parekh, M.D., is a board-certified, practicing pediatrician and a member of the ABC News Medical Unit.
