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ForumsInternationalIreland HSE coverage for Wegovy — looking for input Page 2

Ireland HSE coverage for Wegovy — looking for input

roxy_nash Tue, Jun 25, 2024 at 9:11 PM 13 replies 2,056 viewsPage 2 of 3
TrialTracker_MD
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Jun 26, 2024 at 6:41 PM#6

Adding the numbers, since they settle part of this. Worth knowing that the injection site changes very little. Abdomen, thigh and upper arm are bioequivalent for semaglutide, so a site change is not a plausible explanation for a bad week.

41 19Dr.EM_Chicago, pete_RVA, CarlaRPh_TPA and 38 others
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pat_auckland
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Jun 27, 2024 at 3:14 AM#7

Following on from carl_compliance — and this may be the naive question:

What the dose-response curve actually looks like above 1.7mg, because the trial means hide how few people account for the extra loss?

42 20wanda_boise, NurseAsh_DET, BenResearch_OR and 39 others
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TinaHashiRN
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Jun 27, 2024 at 11:47 AM#8
TrialTracker_MD said:
Worth knowing that the injection site changes very little.

There is a second half to this that has not been said yet. The mechanism that matters here is not stomach emptying, it is central. GLP-1 receptor agonism in the arcuate nucleus stimulates POMC neurons and suppresses AgRP/NPY signalling, which is why the effect is appetite and food salience rather than physical fullness. Delayed gastric emptying largely tachyphylaxes over the first months; the appetite effect does not.

That is the short version; the long version is somebody else's post.

43 21Dr.Martinez, mike_mod, SarahChen_PharmD and 40 others
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roxy_nash
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Jun 27, 2024 at 8:20 PM#9

Closing the loop on my own question.

Update: approved on the third attempt after a peer-to-peer. Nothing about my case changed; only who was doing the talking.

44 22Dr.NephBHM_UK, kim_atl_prep, sarah_TO and 41 others
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DerekSJ_a1c
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Jun 29, 2024 at 1:19 PM#10
TinaHashiRN said:
The mechanism that matters here is not stomach emptying, it is central.

Agreed, though "tolerable" needs defining. A dose you tolerate by eating almost nothing is not tolerated, it is being paid for somewhere else — usually in lean mass, sometimes in adherence three months later.

Last edited: Jun 29, 2024 at 6:19 PM
48 23AttorneyGrant, DebRD_ATL, KristenIndy and 45 others
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