AILSA CHANG, HOST:
Time is running out for people who rely on cheaper alternatives for a name-brand obesity drug. Large specialty pharmacies that were allowed to essentially make copies of Zepbound have to stop tomorrow. NPR pharmaceuticals correspondent Sydney Lupkin has more on how patients are dealing with the change.
SYDNEY LUPKIN, BYLINE: Christina and Jackson Agar, a couple in Minnesota, used to order a pizza and finish it in one night. But an obesity drug changed that.
CHRISTINA AGAR: We ate some of it the first night, and then the next day we had maybe a little bit more. And then we ended up throwing the pizza away because it had gone past the days that you could eat it. And it was so strange 'cause we have never done that.
JACKSON AGAR: No. Never.
LUPKIN: They've each lost about 20 pounds in six weeks. But they're not taking Eli Lilly's Zepbound. Their insurance doesn't cover it. They're taking a cheaper alternative that contains the active ingredient called tirzepatide. It's made by a compounding pharmacy, which is a special kind of pharmacy that's allowed to essentially make copies of drugs during shortages. Christina says she has more energy for their four kids, and Jackson stopped needing to use his sleep apnea machine.
J AGAR: It is completely life-changing to take a bite of these triggering foods and just be, like, enjoy it, say, yep...
C AGAR: Yeah.
J AGAR: ...That was good...
C AGAR: Yeah.
J AGAR: ...And now I'm full.
C AGAR: And now - yeah.
J AGAR: (Laughter).
LUPKIN: But on March 19, the Food and Drug Administration says compounding pharmacies will have to stop making tirzepatide because the agency declared the yearlong Zepbound shortage over. The Agars are worried. Other patients are sad, some more are just angry. In Arizona, Margot Carmichael was in denial.
MARGOT CARMICHAEL: I thought what I think a lot of people perhaps did - oh, it'll be fine. These compounding and telehealth places are making millions off of this and helping so many people, there's no way this is going to stop being available.
LUPKIN: It's been confusing for patients. Some telehealth companies have been telling them they won't be affected. Others have been offering last-minute sales as the FDA deadline nears.
JOSH FRITZLER: So March 19, we are essentially done.
LUPKIN: That's Josh Fritzler, the chief financial officer for Olympia Pharmaceuticals, a large compounding pharmacy in Orlando, Florida. Production will stop, but pharmacies can still dispense Olympia's tirzepatide until it runs out or expires. Olympia has made the medicine for more than 100,000 patients a month.
FRITZLER: They're nervous. They're scared. And we're just hopeful that we can make enough in the time - the time being to fill patients' scripts.
LUPKIN: Smaller compounding pharmacies, which are regulated by states, were supposed to stop in February. Many patients told NPR they have been stocking up on compounded tirzepatide. Carmichael doesn't have health insurance right now. She says she can only afford a small stockpile.
CARMICHAEL: I don't have the money, so I'm going to borrow the money and try to get three more months and stretch it out as long as I can and hope that six to nine months from now, there'll be another solution.
LUPKIN: Eli Lilly sells Zepbound vials at a discount for people not using insurance, but Carmichael says they're still too expensive. She would have to pay $600 a month for a month's supply from Lilly. She's been able to get three months of compounded vials for $500. To keep the Lilly discount, patients like Carmichael would also have to renew every 45 days.
CARMICHAEL: They're making it as difficult as possible for people.
LUPKIN: Some people are talking online about buying the active ingredient from China and mixing the obesity drugs in their homes. They call it the gray market. Here's Jackson Agar in Minnesota.
J AGAR: Look, when you ban stuff, people are going to turn to crazy alternatives because we need this and we don't have that much money.
LUPKIN: But he says the gray market is a risk his family is just unwilling to take.
Sydney Lupkin, NPR News. Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.