" The U.S. health care system has struggled for decades with the tension between providing incentives for pharmaceutical innovation and keeping breakthroughs affordable for those who would most benefit from them. Even as countries around the world have stepped in to require lower-priced drugs for their citizens, the United States has been reticent to do so. As a result, U.S. consumers pay the highest prices in the world for drugs, by a wide margin.

But the impetus for more fundamental reform may come from an unexpected place: America’s obesity epidemic. Many of us are aware that there is a new class of weight-loss drugs that offers enormous promise in addressing obesity. But there is far less awareness of the fact that these drugs also introduce an enormous risk to America’s taxpayers.

The magnitude of potential benefit and potential cost — roughly $15,000 per year per person — posed by these drugs suggests that policymakers may have no alternative but to step in and bring their costs in line with their social benefits. If policymakers succeed in doing so, we could build a model for drug price negotiation that enables an extraordinary medical breakthrough to improve both our health and our fiscal position. Or we could do nothing and create one of the biggest fiscal problems of the decade, with pharma companies profiting at the expense of the taxpayer and of equitable health outcomes." nytimes.com - Ozempic wegovy medicare federal budget