With the emergence of ‘diabesity’ drugs like Ozempic and Wegovy – and recent shortages driven by unprecedented demand – lawmakers are turning their attention to all facets of the diabetes epidemic.

The Senate Health, Education, Labor and Pensions (HELP) committee held a hearing on the matter Thursday, with Sens. Bernie Sanders, (I-VT), and Bill Cassidy (R-La.), exploring two main questions: What is the cause of the diabetes and obesity epidemic, and how can lawmakers make sure treatments are available for everyone?

Some 10% of the American population, or 35 million people, have type 2 diabetes, which is linked to obesity, with 90% of people with the disease being overweight or obese.

Obesity rates, meanwhile, have been steadily growing, with 22 states reporting adult obesity prevalence at 35% in 2022, compared to 19 states in 2021, according to the Centers for Disease Control and Prevention. 

Overall, more than 40% of the U.S. population is obese and those rates are high among adolescents as well, with one in five children living with obesity.

Panel IDs several factors to address

The committee hearing touched on a variety of issues – from food companies advertising high-caloric foods to teens, to the enormously high cost of diabetes drugs like Ozempic, to the need for more federally-funded research into obesity.

Most of what was said at the hearing were things we already know: More Americans need access to healthy, whole foods, patients need affordable insulin and GLP-1s, and stakeholders should embrace the concept of “food as medicine” as a way to improve the mental and physical health of consumers.

One of the expert witnesses at the hearing, Ashley Gearhardt, professor of psychology at the University of Michigan, also referenced food as medicine as a tangible solution to the above issues.

“Teens are getting more calories from ultra-processed foods than any other developmental stage,” Gearhardt explained. “When you can move people to real, nourishing, whole foods, it doesn’t just improve their physical health – but also their mental well-being. [We need to make] nutritious food convenient and affordable so it can compete with some of these other [unhealthy] food products.”

In Sanders’ opening remarks, he pressed that it is time for the U.S. to combat the type 2 diabetes and obesity epidemic and pushed for Congress to take on “the greed of the food and beverage industry which, every day, is undermining the health and well-being of our children.”

Dr. Kasia Lipska, associate professor of medicine at Yale School of Medicine and another expert witness at the hearing, acknowledged the widespread enthusiasm around GLP-1 drugs but quickly turned to Ozempic’s $900-a-month list price. 

“[T]he price tags are simply outrageous,” she said.

Lipska urged Congress to take action in line with other countries, such as Sweden, where Ozempic is priced at $100 a month – or about 10% of what Americans pay. Many European governments directly negotiate drug prices with pharma companies, which force costs down on a broader scale.

“Price negotiation is critical, but I believe we must do more,” Lipska added. “Pharma companies have absolutely no restrictions on the launch prices of their products. No amount of expert negotiation can bring down drug prices years later, when launch prices are sky high to begin with.”

Lipska and other witnesses at the hearing steered the conversation beyond drugs, however, highlighting that medications alone can’t be the solution.

“We must address the upstream causes of obesity – like holding the food industry accountable,” Lipska said. “The bottom line is we have a food industry that profits from making people sick, and a drug industry that profits from treating them. We must break that cycle.”

Room for improvement with insulin

In the spring, three major drugmakers – Sanofi, Novo Nordisk and Eli Lilly – announced they would cut the price of their insulin, capping out-of-pocket costs at $35 a month.

While those caps were welcomed by diabetes care advocates and the Biden administration, the hearing focused on how despite that promise, a large number of patients still aren’t seeing those savings. 

Sen. Maggie Hassan, (D-NH), pointed to the reality that most patients face barriers to accessing the $35 insulin.

Patients must navigate a complex system of manufacturer coupons and online applications in order to access low-cost insulin, Hassan said. 

“While these programs allow drugmakers to say their insulin is low-cost, it can be nearly impossible for patients to navigate,” she added.

In response to the hearing, the Endocrine Society urged Congress to pass legislation that would support diabetes research as well as prevention programs, such as passing the INSULIN Act of 2023 as well as the Treat and Reduce Obesity Act.

The hearing wrapped up with both Sanders and Cassidy reiterating that the issue will remain a priority for the HELP committee moving forward.

“We’re going to have to take on 1,800 well-paid lobbyists from the pharmaceutical industry, and all of the campaign contributions they make,” Sanders said. “This ain’t easy. But for the sake of diabetes and so many other illnesses, it should be a major priority of this committee, and I look forward to working with you to make that happen.”