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Fifty-seven of them said no to the price

Seventy-eight people were offered a weight-loss drug that worked. Twenty-one took it. The rest turned it down because of what it cost.

Carla Medina6 min read
78 people were offered the drug21 started it57 declined — mainly the out-of-pocket costIt worked: −3.2% against −1.4% over the next six weeks.Liraglutide, the oldest of these drugs, given daily.

Most studies measure whether a drug works. This one measured that and, in the same seventy-eight people, how many would buy it — which is the number this site exists for and is almost never reported next to an effect size, any more than the real cost of a course appears next to a trial result.

The setup

174 adults with obesity entered a twelve-week program of diet, activity and education. [1] At week six, anybody who had lost less than 2.5% of their body weight was classed an early non-responder and offered liraglutide for the remaining six weeks.

Seventy-eight people met that definition. Twenty-one accepted. Fifty-seven declined, and the paper names the reason: out-of-pocket cost.

It worked

Between weeks six and twelve, the treated group lost 3.5 kg, or 3.2% of body weight. The group that declined lost 1.3 kg, or 1.4%. p < 0.001.

With liraglutide use, baseline body mass index, sex, age and week-six weight change all entered as variables, only the drug was significantly associated with what happened next. Tolerance was unremarkable: four people reported nausea, two upper abdominal pain.

What the 73% means

Fifty-seven of seventy-eight is nearly three quarters of the people for whom a clinician judged the drug appropriate, declining it on price, inside a study where somebody was explicitly offering it.

That is the demand curve nobody publishes. It sits next to what happened when coverage arrived for one indication and points the same way: this market is rationed by who pays, not by who benefits.

Two limits before anyone quotes the number

The drug is liraglutide — the oldest of this class, a daily injection, and weaker than what most people are choosing between now. A 3.2% figure over six weeks does not read across to a newer molecule.

And twenty-one people is a small treated arm. The direction is clear, the size is not firmly established, and the honest comparison for anyone shopping today is between the molecules actually on sale at what six months of each comes to.

Frequently asked

How many people turned the drug down?
57 of the 78 offered it, which the paper attributes primarily to out-of-pocket cost.
Did it work for the ones who took it?
Between weeks six and twelve they lost 3.5 kg, or 3.2%, against 1.3 kg, or 1.4%, in the group that declined, p < 0.001.
Can I apply this to semaglutide or tirzepatide?
Not directly. This was liraglutide, an older daily injection that produces less weight loss than the newer molecules.
Was the comparison fair?
No group was randomized. The people who took the drug are the people who could afford it, and income was never measured, so it could not be adjusted for.

Sources

  1. [1] Gilardini L, et al. (2026). Effectiveness of Liraglutide in Patients With Obesity Who Are Early Non-Responders to Lifestyle Intervention: A Real-World Study Journal of Obesity. PMID 42658045

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