The high price in the US of weight-loss drugs

The drugs Ozempic and Wegovy, although developed to treat diabetes, have become wildly popular outside its original target population because it seems to be highly effective in reducing weight as well. This has resulted in it becoming harder for diabetics to gain access to the drugs as well as their price rising.

US senator Bernie Sanders has long been a critic of the pharmaceutical industry and how it charges highly inflated prices in the US that are available for much less elsewhere in the world. He has been successful in pushing for the cost of insulin and asthma inhalers to be drastically reduced and now he is targeting Ozempic and Wegovy.

The blockbuster weight-loss drugs Wegovy and Ozempic are arguably as omnipresent in the American zeitgeist as Taylor Swift or the iPhone. The drugs and others in its class are associated with the sparkle of Hollywood, on the lips of Oprah and considered transformative by doctors.

But the giant market for drugs like Wegovy, including not just the roughly 11% of adults who have diabetes but also the 42% of adults who have obesity, has conjured one of the demons of American healthcare – price.

Americans paid 10 times more for Ozempic than patients in the United Kingdom in 2023 – $936 a month compared with $93. Wegovy costs Americans $1,349 a month, compared with $296 in the Netherlands (the drug is not yet available in the UK).

That wild discrepancy has captured the attention of one of the drug industry’s loudest critics, the US senator Bernie Sanders.
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“What we’re focusing on right now is what may end up being one of the best-selling pharmaceutical products in the history of humanity, and that is Ozempic and Wegovy,” said Sanders. “These are very important gamechangers helping people with diabetes and obesity.”

Sanders is preparing to square up against the chief executive of the Danish pharmaceutical giant that makes both drugs, Novo Nordisk. Under threat of subpoena, its CEO, Lars Fruergaard Jørgensen, agreed to testify before the same committee in September. But even for Sanders, the challenge is formidable.

“You’re taking on a company which will make billions of dollars every single year, many billions of dollars from the US, on just this product,” said Sanders. “So, do I think this is going to be a difficult challenge? I do.”

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Supreme Court rejects Sackler deal

The US Supreme Court rejected the bankruptcy deal that had been negotiated by the Sackler family, the people behind Purdue Pharmaceuticals that was responsible for aggressively and falsely marketing opioids to large numbers of doctors and their patients, resulting in the massive opioid epidemic that we currently have in the US that has devastated families and communities. The drug was heavily marketed to doctors as having low risk of addiction, which was not true.

The Sacklers had brought the settlement in front of a friendly bankruptcy judge that effectively shielded much of the vast personal fortunes they had accumulated and instead passed the cost on to the company, which has filed for bankruptcy, on friendly terms, while not having to admit guilt and getting total immunity from future lawsuits that will leave their personal fortunes intact. For more details on why the bankruptcy deal was so bad, see here.
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Visualizing spacetime

One of the insights of the general theory of relativity has been to change our understanding of the relationship between gravity and spacetime. We now say that mass has the effect of distorting spacetime and it is that distortion that causes other objects with mass to move in ways that formerly we used to describe as being acted upon by a gravitational force that could act at a distance.

But visualizing that distortion of spacetime and its effects is not easy because the distortions are not visible in the three spatial dimensions that we can ‘see’ and must be described mathematically.

However, this video makes a valiant effort.

Cars powered by sea salt batteries

As the move from gasoline to electric cars gains steam, there is an increasing demand for batteries and the raw materials like lithium, cobalt, and nickel that make them up and the competition for those fairly rare resources is becoming fierce.

So I was pleased to learn that there is an alternative battery power source that is made from plain old salt.

Lithium – the main component in most electric batteries – can be costly to mine. But researchers have made a breakthrough with alternative ‘molten salt’ batteries.

Your electronics could soon be powered by an ultra cheap sea salt battery.

Researchers have built a new cheap battery with four times the energy storage capacity of lithium.

Constructed from sodium-sulphur – a type of molten salt that can be processed from sea water – the battery is low-cost and more environmentally friendly than existing options. 
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Lessons of Covid for the next pandemic

Public health experts say that another pandemic is inevitable, that it is not a question of ‘if’ but when and what form it will take. So what lessons have we learned from the Covid-19 pandemic we just had (and that still lingers on) that we can apply to the next one?

Clearly scientists and health experts were scrambling to contain the virus and various measures were adopted, not all of them successful. Some will depend on the nature of the virus itself and how it is transmitted. If it is in the form of droplets that fall, then physical distancing will help though the distance required may be different from the six feet that we were told. If the virus is transmitted in the form of aerosols that float through the air and linger longer, distancing may not help. But in either case, masking helps but only if we use high quality N95 or KN94 masks and not the paper or the homemade cloth ones. So having a stockpile of those good masks at the ready to hand out to the public would be a good idea.

Avoiding crowded indoor spaces where lots of people gather is also recommended. If one has to be indoors with others, it would be better if the place is well ventilated.

Working at home, if possible, is probably beneficial. When it comes to closing down schools, offices, and restaurants, the cost-benefit analysis is more complicated.

One positive thing that came out of this pandemic is that scientists seem to have developed new techniques to quickly identify the nature of the virus and develop vaccines for it. Of course, that will not help much if the same nutters who opposed vaccinations the last time around are still vocal.

Kevin Drum provides a comprehensive list other the measures that were taken and how effective they were.

Sacrificing functionality for style

I recently got a ride from a friend in his Tesla and he showed me the many electric features that have replaced formerly mechanical ones, like a button that when touched opens the door, rather than a latch that you pull to release the catch. Many of the familiar knobs and buttons were gone, replaced by a touch screen. My friend showed me how the screen showed the presence of people and trash cans on the sidewalk, which I could also see by looking through the windshield. It seemed like the design emphasis was on looking cool and slick rather than boring old functionality. I am not particularly impressed by tech gimmickry that does not provide substantial benefits in functionality and so was somewhat underwhelmed.

But it appears that there is a serious downside to having everything be electric-powered as a woman found out when she was trapped inside her Tesla when the battery unexpectedly died and she discovered that she could not open the door or windows.
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Public health safety measures that would never pass now

The Surgeon General Vivek Murthy has been warning of the dangers of social media on young children and proposes warning labels for them. I am not sure what form that it will take and how effective it would be (assuming that it ever gets enacted) but it did make me think of one of the biggest positive acts by a former Surgeon General and that was the warning labels on tobacco packs promoted by his predecessor C. Everatt Koop. “As Surgeon General, he released eight reports on the health consequences of tobacco use, including the first report on the health consequences of involuntary tobacco smoke exposure. During Koop’s tenure as Surgeon General, smoking rates in the United States declined significantly from 38% to 27%”.

Thanks to actions like those taken by the government in those days, we now have cleaner air and water, fluoride in the water, and bans on the widespread use of some pesticides like DDT.

We also had the ban on chlorofluorocarbons (CFCs) that were destroying the ozone layer. That story of how the fight against that harmful chemical was won by scientists can be read here.
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Senseless deaths

Common sense would tell you that when temperatures rise to extraordinarily high levels, you should avoid exertion and stay indoors. The hajj pilgrimage in Mecca, Saudi Arabia undertaken by devout Muslims is done outdoors and is pretty grueling at the best of times. But when it is done during a heat wave, it is positively dangerous, and so it proved this year when temperatures reached 125F.

At least 550 pilgrims have died during the hajj, underscoring the gruelling nature of the pilgrimage which again unfolded in scorching temperatures this year.

At least 323 of those who died were Egyptians, most of them succumbing to heat-related illnesses, the two Arab diplomats coordinating their countries’ responses told AFP.

“All of them [the Egyptians] died because of heat” except for one who sustained fatal injuries during a minor crowd crush, one of the diplomats said, adding that the total figure came from the hospital morgue in the Al-Muaisem neighbourhood of Mecca.

At least 60 Jordanians have died, the diplomats said, up from an official tally of 41 given earlier on Tuesday by Amman.

The new deaths bring the total reported so far by multiple countries to 577, according to an AFP tally.

The diplomats said the total at the morgue in Al-Muaisem, one of the biggest in Mecca, was 550.
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Saudi authorities have reported treating more than 2,000 pilgrims suffering from heat stress but have not updated that figure since Sunday and have not provided information on fatalities.

At least 240 pilgrims were reported dead by various countries last year, most of them Indonesians.

The hajj is one of the five pillars of Islam and all Muslims with the means to must complete it at least once.

The pilgrimage is increasingly affected by climate breakdown, according to a Saudi study published last month that said temperatures in the area where rituals are performed were rising 0.4C (0.72F) each decade.

Temperatures hit 51.8C at the Grand Mosque in Mecca on Monday, the Saudi national meteorology centre said.

It is madness to choose to go out in such temperatures. These people died because of their religious fervor.

Another monolith appears!

In 2020 there were several gleaming monoliths similar to the one that was shown in the classic film 2001: A Space Odyssey that mysteriously appeared in remote areas of the world. As far as I am aware, the question of who was responsible was never solved.

Now yet another monolith has appeared, this time in the Nevada desert.

Las Vegas police said on the social platform X that members of its search and rescue unit found the otherworldly object over the weekend near Gass Peak, part of the vast Desert National Wildlife Refuge where bighorn sheep and desert tortoises can be found roaming. At 6,937 feet (2,114 meters), it is among the highest peaks in the area north of Las Vegas.
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In November of [2020 a similar metal monolith was found deep in the Mars-like landscape of Utah’s red-rock desert. Then came sightings in Romania, central California and on the famed Fremont Street in downtown Las Vegas.

All of them disappeared as quickly as they popped up.

The Utah structure, which captured the world’s imagination during the pandemic, is believed to be the first in the series. It stood at about 12 feet (3.6 meters) and had been embedded in the rock in an area so remote that officials didn’t immediately reveal its location for fear of people getting lost or stranded while trying to find it.

Hordes of curious tourists still managed to find it, and along the way flattened plants with their cars and left behind human waste in the bathroom-free backcountry. Two men known for extreme sports in Utah’s sweeping outdoor landscapes say it was that kind of damage that made them step in late at night and tear it down.

The article does not give the dimensions of the latest monolith but whatever its size, it is a pretty impressive stunt to pull off.

Is raw milk the new right wing thing?

The MAGAnuts have been relentless in their efforts to promote alternative realities that postulate that well-respected institutions that are science-based are actually part of a secret cabal that is trying to … well I don’t know what exactly but whatever it is, they tell us that those institutions should not be trusted. In pursuing that goal, they have been promoting alternative theories that go against the scientific consensus in many areas. If the scientific community argues for vaccines, they claim that vaccines are actually harmful. If the scientific community points to the dangers of greenhouse gases and global warming, they say that emitting those gases is good for the environment. It seems like they seize of anything that the FDA, NIH, EPA, and other organizations recommend to promote public health and oppose it. ‘Experts’, you know the people who spend decades studying issues and building up evidence to reach reliable conclusions, are dismissed as know nothings or, worse, as positively evil with a nefarious agenda.

Now these people are arguing that pasteurizing milk is not necessary and can actually be bad for you and that unpasteurized (so-called ‘raw’) milk is to be preferred. See this letter put out by raw milk advocates that asserts the alleged benefits of raw milk that is ‘carefully produced’.
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