Ozempic IRA Negotiations, GLP-1 State Coverage Requirement, Non-Addictive Pain Meds

Hey all,

Hi from San Francisco! We’ve got a lot of GLP-1 news today. Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Cost Curve) Ozempic and IRA Price Negotiations: Four Likely Scenarios 

The CMS is expected to announce semaglutide (Ozempic/Wegovy) as a key target in the next round of Inflation Reduction Act (IRA) drug price negotiations, prompting speculation about how pricing will be set. Potential outcomes include maintaining the status quo, aggressive price reductions, politically motivated decisions, or legal challenges regarding CMS’s authority to group drugs with the same molecule. Each scenario underscores the uncertainty surrounding IRA implementation and its impact on drug access and healthcare costs. Full Article

(BenefitsPRO) North Dakota Adds Wegovy-Like Drugs to Essential Health Benefits

North Dakota is the first state to include drugs like Wegovy and Zepbound in its essential health benefits (EHB) package, providing coverage for morbid obesity, diabetes, and metabolic syndrome under small-group and ICHRA health plans. This policy, effective January 2025, could set a precedent for addressing obesity on a broader scale. It also may conflict with drug manufacturers' rebate strategies aimed at limiting patient restrictions. Full Article

(Washington Post) Non-Opioid Pain Pill

Vertex Pharmaceuticals has developed suzetrigine, a non-opioid pain medication that selectively inhibits Na_v1.8-dependent pain-signaling pathways in the peripheral nervous system. The drug has completed two phase 3 clinical trials, showing promise in relieving moderate-to-severe post-surgical pain without the addictive potential of opioids. Vertex has submitted a New Drug Application to the FDA, which has granted priority review with a target action date of January 30, 2025. If approved, suzetrigine could offer a safer alternative for pain management, addressing the ongoing opioid crisis. Full Article