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Topher Spiro Profile picture
@TopherSpiro
Nov 6 • 7 tweets • 1 min read • Read on X
You will be shocked to learn that Trump's obesity drug announcement was a scam that the press parroted uncritically.
nytimes.com/2025/11/06/hea…
First off, the headline $149 price is only for a future pill (pills cost less than injectables), and only for a starter dose of 4 weeks. 4 weeks!
The $245 Medicare price is a direct result of Medicare drug negotiation! Thank you President Biden! Trump delayed the release of the Biden Medicare-negotiated prices so he could repackage them and take credit.
What's more, Biden actually *expanded* Medicare coverage of obesity drugs dramatically. One of the first things Trump did was repeal that policy.
So whereas the $245 would have been available to a much bigger population under Biden, now the eligible population is significantly curtailed.
Now let's dissect the $350 price on TrumpRx (which just redirects you to the manufacturers). This is for people who can afford that price outside of health insurance. A small number.
Is it a discount from the $499 that manufacturers currently charge this small population? Yes. But the fact is that they are facing very stiff pricing competition from compounded versions (think Ro, Hims).

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More from @TopherSpiro

Topher Spiro Profile picture
Jan 28
As a former associate director at OMB, I have some thoughts about this OMB memo...
1. I have no doubt that OMB lawyers would believe this is illegal.
2. I know Matt Vaeth. This memo reads like a hostage note written directly by Russ Vought, who is not confirmed.
Read 5 tweets
Topher Spiro Profile picture
May 6, 2020
THREAD: Several big states - CA, NY, IL - appear to be relying on hospitalizations, rather than incidence, as their key threshold for reopening. Here's why that's a mistake:
For starters, it's become clear that people are dying in their homes. So while hospitalizations are one measure of severity, it's one measure.
As @mattyglesias has argued, relying on hospitalizations suggests a focus on mitigation to flatten the curve and ensure hospital capacity. But that's not all we should care about...
Read 11 tweets
Topher Spiro Profile picture
May 4, 2020
NEW: Evidence-based thresholds states must meet to safely reopen their economies. No state currently meets thresholds for both incidence and testing.
americanprogress.org/issues/healthc…
Here are the incidence thresholds compared to current incidence. Only 8 states—Alaska, Hawaii, Idaho, Maine, Montana, Oregon, Vermont, and West Virginia—currently meet this threshold.
Nationally, the U.S. is at about 29,000 new cases per day. We need to get down to about 5,800 to control spread. This would achieve South Korean incidence levels.
Read 7 tweets

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