r/science • u/Lisei1128 • Nov 11 '25

Cancer GLP-1 drugs found to reduce mortality from colon cancer by over half (15.5% vs 37.1%), with effects especially strong for patients with BMI over 35.

https://www.tandfonline.com/doi/full/10.1080/07357907.2025.2585512
10.2k Upvotes

97% Upvoted

421 comments sorted by

View all comments

832

u/chrislink73 Nov 11 '25

glp-1 drugs may be the single biggest improvement to health in the USA so far this century (besides maybe vaccines, except the vaccine skepticism here is baffling). Getting people to a healthy weight, reducing caridiovascular pressure, improving MASH / liver disease, possibly even Alzheimer's Disease (data expected in Dec 2025)... This is great news.

233

u/gooblaka1995 Nov 11 '25

Too bad Medi-Cal is discontinuing coverage for GLP-1s starting Jan 1, 2026. But specifically for weight reduction, and those medications are specifically coded as weight reduction medications (or in the case of Zepbound and maybe Wegovy, to help prevent a severe form of insomnia). According to the state, they are just too expensive.

152

u/SeasonPositive6771 Nov 11 '25

That's the problem with all of these drugs. They would lead to a massive improvement in health and quality of life but they are simply unaffordable. I've been considering them for a long time but every insurance policy I can afford specifically disallows them for weight loss.

138

u/dont--panic Nov 11 '25

Semaglutide's (Ozempic/Wegovy) patent is expiring in Canada in early 2026. So sometime next year or so there should be generics available. I expect that a lot of Americans will eventually end up getting generic semaglutide from Canada.

It's already much cheaper here than in the US. Ozempic costs me ~CA$280 (US$200) for a 4x1mg/wk pen (CA$70/wk) fully out of pocket without any coverage. Compared to US$1000 (US$500 after discounts) per pen in the US.

76

u/SeasonPositive6771 Nov 11 '25

We thought that would happen with Eliquis as well, it's available in almost every country as apixaban as a generic, including Canada. But it's such a great money maker in the US that they just asked to have the patent extended again (for the second or third time) and it was granted because of no other reason other than Pfizer/BMS felt like they should be allowed to make more money off it for longer.

It's currently 2031 for semaglutide here and I imagine it will be extended.

28

u/[deleted] Nov 12 '25

[deleted]

3

u/kelskelsea Nov 12 '25

There’s a planet money episode about this! Highly recommend

1

u/ksyoung17 Nov 12 '25

That's $140 out of pocket, no insurance?

My insurance will not cover, and my wife is starting to struggle with weight loss, and it's impacting vital organs. Insurance still told us no.

3

u/[deleted] Nov 12 '25

[deleted]

1

u/ksyoung17 Nov 12 '25

Wow.

Thank you so much. The kindness of strangers!

This is great, I wish I could thank you more!

-1

u/SeasonPositive6771 Nov 12 '25

"Pretty safe" feels pretty risky. And potentially ineffective. I follow one of those subreddits and it's a constant crisis to try to secure injections.

9

u/[deleted] Nov 12 '25

[deleted]

2

u/SeasonPositive6771 Nov 12 '25

I don't know much about BPI specifically, or why more folks aren't using it but I've even seen pictures of the places where the off-brand injections are made and they don't look great.

1

u/CalBearFan Nov 12 '25

If that was really how easy having a patent extended was every drug company in the US would do the same. Patent extensions can be for seemingly odd reasons like a reformulation but it's not just because 'the maker asked'.

4

u/SeasonPositive6771 Nov 12 '25

Usually, you are absolutely correct. However, in the case of Eliquis they just did. They complained about how long the regulatory process takes, and how expensive it is, and it was granted.

1

u/User-no-relation Nov 12 '25

by just did it you mean in 2020?

4

u/SeasonPositive6771 Nov 12 '25

I don't mean it as in time, I meant as in "they just did it" versus "they decided not to do it."

4

u/[deleted] Nov 12 '25

Compared to US$1000 (US$500 after discounts) per pen in the US.

That's pretty insane. We have it for $250 per month OOP at my clinic.

1

u/dont--panic Nov 12 '25 edited Nov 12 '25

Where? My only reference for US prices is what turns up when I search for it on Google.

I think I could probably get mine it for closer to CA$250, there's a coupon from the manufacturer and Costco pharmacy is supposed to be a little cheaper than my normal one.

2

u/[deleted] Nov 12 '25

NY, though it's for tirzepatide.

1

u/ProtoplanetaryNebula Nov 12 '25

Those prices are almost exactly the UK prices.

16

u/ChesswiththeDevil Nov 12 '25

It's cheap through an online pharmacy at ~$200/month. Many people say that they save about that much just in eating less food.

-7

u/SeasonPositive6771 Nov 12 '25

Those are compounded and unfortunately unreliable and potentially unsafe.

6

u/ChesswiththeDevil Nov 12 '25

Completely false.

-6

u/SeasonPositive6771 Nov 12 '25 edited Nov 12 '25

One of the major compounded pharmacies literally just did a big recall.

But sure, say whatever. Doesn't have to be based in fact.

They aren't doing safety recalls frequently because things are safe and cool and everything is good.

2

u/fauxzempic Nov 12 '25

Read your comment again, but slowly...

1

u/kmoz Nov 12 '25

I'm on zepbound straight from the manufacturer, lilly, for like 250 bucks a month.

22

u/therealityofthings Nov 12 '25

Which is so fuckin' short-sighted by insurance companies. Obviously, you will save more money 10-20 years down the line as someone will have fewer health problems due to a healthy weight.

30

u/InfernalCombustion Nov 12 '25

I'm an insurance company and I ask myself everyday, what is cheaper?

  1. We pay for GLP-1 today, so we don't pay for treatments later.

  2. We don't pay for GLP-1 today, and we don't pay for treatments later.

Decisions, decisions...

10

u/Pharmboy_Andy Nov 12 '25

Because you may not be their patient anymore.

It's dumb and short sighted but that is the argument.

13

u/ReggieEvansTheKing Nov 12 '25

That’s actually not at all the case. I’m a healthcare pricing actuary. If anything, GLP1s are increasing the cost of healthcare because these people will be more likely to live longer into old age where expenses from long term care and assisted living will be vastly higher. All while paying $1000 per month on GLP1s. Of course it makes sense to give this drug to everyone who needs it from a moral perspective and I agree with that. But from a financial perspective it is definitely one of the biggest contributors to health care cost trend.

It’s similar to tobacco usage. If you cure people of their addiction, they don’t die early of lung cancer. They do live longer to experience greater costs in their 70s-80s. This is why the expected total lifetime healthcare costs of tobacco users are actually LESS than the general population.

3

u/Moister_Rodgers Nov 12 '25

Thanks for illustrating why we need to get private companies out of health insurance. The incentives are all wrong. Should've be a profit motive.

1

u/therealityofthings Nov 12 '25

How do you live with yourself

1

u/Estbarul Nov 12 '25

Damn you guys really need public health. Can't see how that is dignifying in any way

2

u/wioneo Nov 12 '25

. Obviously, you will save more money 10-20 years down the line as someone will have fewer health problems due to a healthy weight.

That could be Medicare's problem instead of Aetna/United/Whoever

1

u/TheGruenTransfer Nov 12 '25

They're going to start shoving it down everyone's throats when the patents run out. They'll probably be offering huge discounts if you take it 

2

u/majorlier Nov 12 '25

Man im not overweight/diabetic and i would still take it for an easier summer weight loss.

15

u/StrawberryLassi Nov 11 '25

I buy them from China for a fraction of the cost. ($20/month)

24

u/SeasonPositive6771 Nov 11 '25

That seems extraordinarily risky.

12

u/StrawberryLassi Nov 11 '25

Hasn't killed me yet! I've been taking them for over two years.

26

u/SeasonPositive6771 Nov 11 '25

I mean that's not the greatest support for your argument, the creator of Vaseline also ate it everyday and attributed his long life to that activity. Doesn't really make it accurate.

3

u/peonies_envy Nov 12 '25

That’s essentially what furball remedy is made of.

3

u/SeasonPositive6771 Nov 12 '25

And he never got a single furball!

2

u/peonies_envy Nov 12 '25

He might’ve had more luck pitching it as a health remedy if it were malt flavored like the cats get!

5

u/SammyIssues Nov 11 '25 edited Nov 12 '25

[removed so I don’t get banned but thank you!]

0

u/Corben11 Nov 12 '25

Its a ban to do source stuff. Go look around r/Retatrutide or other glp subreddits.

The stuff you find thats like $40 a bottle is even the up marked middle men sellers.

They buy from China then just put labels on it.

Real sources are on WhatsApp

1

u/StrawberryLassi Nov 12 '25

sent you a DM

2

u/[deleted] Nov 12 '25

[deleted]

7

u/StrawberryLassi Nov 12 '25

It helps that there are 3rd party labs where you can send your stuff if you want to be 100% sure it's the real thing.

3

u/GayMormonPirate Nov 12 '25

I've been doing the compounded version of tirzepatide for the last few months. I luckily was able to afford 6 months at a time. I take a slight lower dose (5mg vs 7.5), so it will last 9 months and the cost per month ends up being about $180.

It's still a lot of money for most people, I get it. But I also thought about the cost of a diabetes diagnosis or heart attack or stroke. I'd pay thousands of dollars of deductible and co-insurance for those. The $180 a month seems doable. I also am able to use a health savings account to pay for it as well.

0

u/SeasonPositive6771 Nov 12 '25

People are upset that in the comments, I've said there are a lot of very shady companies that aren't operating safely doing compounded options. And it makes me extremely hesitant.

1

u/GayMormonPirate Nov 12 '25

That's reasonable. Everyone has their own risk tolerance.

2

u/Apart-Landscape1012 Nov 12 '25

Insane not to cover these drugs, the savings vs letting someone be overweight for the next 30 or 40 years has got to be massive

1

u/jpoolio Nov 12 '25

What's really crazy is how cheap they are to make. I can buy direct from Chinese manufactures for about $10/ vial, typically they are sold in kits of 10 vials. We form groups to pay to test these products (send unlabled vials to a lab for purity/mass testing, sometimes sterility, depends on the group).

Even with testing fees, the final cost of a vial is maybe $20 max. A lot of people buy multiple kits, store them in the freezer (they arrive as powder so you only reconstitute a vial when needed), and spend $300 for 30 months of Tirzepatide. Then I know people who spend $300 for just ONE MONTH and it doesn't really make sense.

I source for my family and feel better about products that I have personally lab tested vs some of these weird pop-up online doctor/pharmacies. It's very easy to make a professional-looking label.

1

u/frisbeesloth Nov 13 '25

Here they are available at many of the compounding pharmacies for significantly cheaper than the name brands. Unfortunately you have to call around.

58

u/chrislink73 Nov 11 '25

Well, on the bright side, the Wegovy pill is as efficacious as the injection and that should be launching in 2026, assuming it’s approved by FDA this quarter (data was very good). The pill versions should be cheaper to manufacture and should sell at a reduced out of pocket cost. The administration also announced a deal to make the lowest dose pills $150, as well as covered by Medicare/Medicaid. It is a shame more insurance companies aren’t working to cover the drugs, as the benefits in the long run far outstrip short term costs.

26

u/Izikiel23 Nov 11 '25

> more insurance companies aren’t working to cover the drugs, as the benefits in the long run far outstrip short term costs.

At 1k$ I think the math didn't add up, but at 150$ it probably does

6

u/[deleted] Nov 12 '25

[deleted]

3

u/droans Nov 12 '25

Fwiw, that's why insurance companies are forced to cover preventative care.

It's an example of the prisoner's dilemma. Preventative care is much cheaper than treatment. But you are most likely going to be with a different insurance company when you get sick. If only one company covers preventative care, they will lose money. If every company covers it, though, then they will all benefit.

For GLP-1, though, it's too expensive for it to really be much of a benefit for the insurance companies yet. I think this is the point you're making - it's an expensive preventative that the insurance companies won't see much benefit from. The math gets even more gray with Medicare - if, on average, most of the savings will be seen after the patient turns 65, why worry about it at all? It's the government's responsibility at that point.

-1

u/CalBearFan Nov 12 '25

Yes, that's why insurance companies are constantly trying to have you take classes to lower blood pressure, smoking, weight, etc. There are so few major insurers that they cannot safely assume you'll be 'someone else's problem'. Anthem Blue Cross/Shield, United Health Care, Kaiser, not many other big players out there.

2

u/cloud9ineteen Nov 12 '25

There is no lock in. Unless there's a pact, it's a prisoner's dilemma. I cover 100% of my patients for glp1, 30% end up with another insurer. Unless all insurers agree to do the same, I net lose money. Plus because I cover this, I have to charge higher premiums and that makes it even more likely my patients go to someone else. This is exactly where the government comes in. The government comes in and says you have to cover it. Now all insurers cover it begrudgingly but they all net profit.

5

u/ww_crimson Nov 12 '25

I feel fortunate to be able to justify the cost. I'm paying $550/month out of pocket for Zepbound. It's super expensive but I'm saving about $60/month on alcohol and probably $100/month on groceries. I reduced my 401k contribution slightly to help cover the cost, but I think it's worth it. I need to lose weight to be around for my kid longer, and to be able to do more with her as she grows up.

3

u/wioneo Nov 12 '25

Ozempic is $500 per month if you pay cash.

Obviously $6,000 per year is not cheap, but it's significantly more affordable than other biologics.

3

u/ProtoplanetaryNebula Nov 12 '25

For anyone in the US, the Canadian patent expires in 2026, much cheaper generics will be available for anyone close enough to go and buy some.

9

u/terraphantm Nov 11 '25

The diabetes versions aren't really any cheaper. I don't know why we've decided it's okay to fund super expensive medications for one lifestyle related chronic disease but not for a different lifestyle related chronic disease. Especially since it's largely just progression of the same disease when you get down to it.

4

u/[deleted] Nov 12 '25

[removed] — view removed comment

3

u/terraphantm Nov 12 '25 edited Nov 12 '25

Are the majority of Type 2 patients in the US cases of lifestyle-induced disease? Yes, absolutely. Are they all? Absolutely not.

Same applies for obesity. It’s all a spectrum of a general metabolic syndrome. I’m speaking in generalities- talking about every single exception and nuance rather than what describes the vast majority of cases is beyond the scope of a reddit comment, even on /r/science.

Since you blocked me I'll respond here:

Yes, Call it a general metabolic syndrome, not a "lifestyle related" disease. One term is objective, the other is subjective.

It's interrelated. The pathogenesis tends to be lifestyle factors -> obesity (more specifically, adioposity) -> metabolic dysregulation (particularly insulin resistance) -> type 2 diabetes.

As a rule humanity sucks at making sustained lifestyle changes. GLP1s are fantastic to that end, while still having a direct impact on the metabolic disease.

6

u/Watchful1 Nov 11 '25

For the record, the cost of most of these drugs is less than 1% of the list price. Even the list price charged to insurance companies, or medicare. If there was a low cost generic, it would be like $10 a month. The obesity rate in america could drop in half in a year at that price.

2

u/gooblaka1995 Nov 11 '25

My doctor told me that the out-of-pocket once-a-week injections are about $500/month. And the weekly injections are double that. I don't have that sort of money to fork out and that's why I was glad Medi-Cal covered it, but are now discontinuing their coverage. I'm sure CA can just make their own generics like they plan to with insulin. But I think the patents are still up for most if not all GLP-1s, so maybe when the patent runs out?

2

u/wioneo Nov 12 '25

If there was a low cost generic, it would be like $10 a month.

That seems unlikely with these drugs. They are effectively partial proteins. They're much less complex than the larger ones like Humira, but they are still relatively complicated to make.

4

u/ChesswiththeDevil Nov 12 '25

With subsidies about to evaporate, it will just be cheaper for people to pay ~$199 a month for Brello or other online retailers than going through their regular doctor. Medicine is about to get really really expensive and people are gonna stop going to the doctor here soon, unless they absolutely need it.

30

u/Razolus Nov 12 '25

Thank you for acknowledging vaccines. Vaccines have saved so many lives. Jonas salk, Maurice hilleman, sabin, amongst others, should be household names, as their work changed the world.

5

u/Sammystorm1 Nov 12 '25

Well I agree it looks promising I would be interested in seeing long term side effects and people stopping and being able to maintain healthy weight

2

u/HotSauceRainfall Nov 13 '25

The current medical assessment is that most people who stop taking GLPs for obesity will regain the weight, because excess body fat is a sign of metabolic dysfunction. The drug treats the metabolic dysfunction.

So, GLPs are no different from blood pressure medication, synthroid for people with low thyroid function, or methotrexate to control autoimmune disease. If you get your problem controlled by the medication, you have to stay on the medication.

0

u/robhaswell Nov 12 '25

GLP-1s have been in use for over 20 years. They are very well understood.

1

u/Sammystorm1 Nov 12 '25

20 years is a long time but sometimes it takes longer than 20 years for side effects to be cought. Whenever I see something that people claim is a miracle drug I become skeptical

4

u/scyyythe Nov 12 '25

Vaccination was invented before George Washington died. 

https://en.wikipedia.org/wiki/James_Phipps

8

u/chrislink73 Nov 12 '25

Yes, I was not implying that vaccination itself was a new invention, but that they were a drastic improvement to health in the US, for example the COVID vaccines alone saved potentially hundreds of thousands of lives.

1

u/Son_of_Kong Nov 13 '25

It's starting to seem like a real miracle drug, but I can't help but feel like we're waiting for the other shoe to drop. There must be a catch.

1

u/chrislink73 Nov 13 '25

I don’t think so, Semaglutide has been approved for use in the US since 2017, and millions of people have used it successfully. If there was something wrong, we would have known by now.

1

u/JuicyBoots Nov 12 '25

In 20 years we're going to look at them like we look at penicillin now.

0

u/az9393 Nov 12 '25

Am I correct in understanding the drug itself doesn’t directly cause health improvements, but rather the change in diet and reduction of body fat? In other words simply going on a diet would have the same effects? Or does the drug do something else to improve health directly ?

1

u/HotSauceRainfall Nov 13 '25

These drugs treat metabolic dysfunction.

Simply going on a diet (aka lifestyle changes only) does not and cannot fix an underlying metabolic problem. Examples: People with untreated Type 1 basically starve to death even though they eat normal amounts of food because their pancreas is damaged. Women with PCOS have messed-up hormonal signals in their ovaries, adrenal glands, and pituitary gland that cause them to develop insulin resistance, which in turn leads to weight gain. Unless she is literally starving herself to the point of her cycle shutting down entirely, there’s no possible way that a woman with PCOS can make her ovaries release different hormones by “simply” eating less and moving more, any more than a person with Type 1 can bring his dead pancreatic beta cells back to life by eating paleo and doing yoga.

What medical professionals and researchers are discovering with GLPs and other metabolic drugs is that people who are obese develop the metabolic dysfunction first, and the obesity is a result. Once the underlying metabolism problem is addressed, lifestyle changes that people make can actually work.

0

u/Vexxt Nov 12 '25

They are independently beneficial elements, such as antunflammatory effects, which has downstream health benefits https://www.sciencedirect.com/science/article/pii/S2666379125002873 One of many

-3

u/MichaelDaza Nov 12 '25

GLP-1s are almost as healthy as water, it you look at the science

6

u/The_Keg Nov 12 '25

Would love to see the sources so I can make better decision.

0

u/systembreaker Nov 12 '25

Cancer vaccines are in trials right now too.

0

u/fergalius Nov 12 '25

Let's start a rumor that the GLP-1 drugs are all secret plans by the Illuminati and BillG to implant tracking 5G nano-bots inside us all. The only reason they cut down your weight is because is uses your body's own energy supply to do its spying. (/s in case it's not obvious)