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More than two-thirds of people in the United States are overweight or obese, of whom 40% have a BMI above 30. According to a report released by McKinsey in 2014, the socioeconomic burden of obesity each year reached $2 trillion, and this number is still rising.
The diet pill market is quite large. According to estimates by some market data companies, the United States spends about 60 billion U.S. dollars annually on some unapproved weight-loss drugs and devices.

 

Since 2012, the FDA has approved four diet pills, including Visus’s Qsymia (Ptamine/Topiramate, 2012/7/17), Arena’s Belviq (Calocinine, 2012/6/27), Orexigen’s Contrave (bupropion/naltrexone, 2014/9/10), Novo Nordisk’s Saxenda (liraglutide, 2014/12/23). However, as of now, these slimming pills have been mediocre after being listed, and they are far from the anticipated bombings of the one billion yuan before the listing. The reasons for this boil down to the following points:

 

1. The doctor is reluctant to prescribe

The doctor’s willingness to prescribe a diet pill is not much improved from three years ago. The traditional training received by doctors did not consider obesity to be a disease. This view was not changed until the annual meeting of the American Medical Association (AMA) representative meeting in June 2013. At that time, the delegates voted with 276:181. The result was a resolution passed by a number of professional organizations requesting AMA to recognize obesity as a disease state and adopt a series of interventions to promote obesity treatment and prevention in its multiple pathophysiological aspects.

 

The AMA’s decision to “obey obesity requires treatment” is as difficult as winning a war because it needs to mobilize the entire health care organization to treat obesity, not just heart disease, type 2 diabetes, etc. Secondary diseases. Although AMA won the war, the impact on doctors’ clinical practice is still very weak.

When it comes to diet pills, doctors will inevitably recall sibutramine and Rimonabant who had previously withdrawn from the market. Both of these drugs have been used clinically for a long time but have been withdrawn due to serious adverse events such as cardiovascular events, stroke, depression and suicidal tendency. This allows doctors to be very cautious when prescribing diet pills, and not because of subtracting several drugs. Pound weight and take the risk of safety. Doctors are also more likely to let patients lose weight through exercise and diet control. Therefore, if diet pills want to open up the market, they may also need a long process of doctor education.

2. Insurance is not willing to pay

There may be only one layer of insurer between the diet pills and the patient, and part of the Medicare Part D even prohibits paying for the diet pills. Medicare is willing to pay for the downstream diseases of obesity, but is not willing to pay for the diet pills, indicating that Medicare does not think that obesity is a disease.

If they are not covered by medical insurance, patients will generally have little willingness to purchase this “icing icing” drug at their own expense. After all, the price of diet pills is not cheap. It is also crucial for diet pills to open up the market, and to reverse and change the payment policy of the health care provider.

3. The patient does not believe in the efficacy

On the one hand, doctors do not trust the safety of diet pills. On the one hand, many patients are not convinced of the efficacy of diet pills. Because the efficacy of diet pills is usually very mild, it is not immediate, and it is easy to rebound.

For example, a patient weighing 200 pounds loses 50 pounds (25%) of his body weight. When he sees a drug that can only lose 5% to 10% of his body weight, he often feels he does not meet expectations. In fact, losing 10% of your body weight is only an average result. Even if you only lose 10% of your body weight, your cardiovascular benefits are enormous. Patients also need to be educated.

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