Obesity as a Disease - Medication

I contacted PillSorted in the UK as they seemed to be the cheapest for a once off 15mg pen (they give a £40 discount off your first pen) and they seemed to have no problem posting it to Border Parcel Motel in Belcoo. However, because I am now under a normal BMI, they would only prescribe me the 5mg pen for maintenance, despite me showing evidence of my prescription - dated in the last six weeks - from my GP. So that was the end of that. McKeagneys in Newry seem to be the cheapest otherwise. £309 for the 15mg dose plus £15 for delivery. Corrys isn't much more expensive, £340 including delivery. Since I spent too much time messing around with Pillsorted and because Corrys already have a copy of my prescription, I just went with them.

If you are still over a BMI of 30, and have day-to-day health insurance with ILH or VHI, the cheapest option is myBMI. MyBMI won't take you on as a new patient unless you are over the BMI 30 mark, even if you have been on MJ for some time. They split the cost of getting the 15mg pen between a "consultation" and the cost of the pen itself, with the majority being the consultation. If you have, say, the VHI plan where you can get 75% back on GP fees, it can work out as significantly cheaper than any other supplier. The only thing is that this is a monthly subscription service, so you can't be counting the clicks on the 15mg pen, taking a lower dose and getting the pen to last 6+ weeks. You have to pay for the consultation and new pen every month. If you were willing to do that, and let a few pens build up in your fridge, then it probably would be cheaper over the course of a year.

I've decided that this 15mg pen that is on it's way to me will be my last highest dose pen. I'm 146lbs now, nearly 60lbs lost, and really happy with my weight loss and how I look. I'd like to get to 140lbs, and then I will start titrating downwards. I expect that a maintenance dose for me will be between the 5mg and 7.5mg dose, and I'll aim to go verrrrrry slowly down to that point over the course of six months. I understand that I might put back on 5-10lbs while my body/brain settles into the right place, hence why I'd like a little buffer of getting down to the 140lb mark. I understand that my hunger will come back (unfortunately, because I enjoy not being hungry) and my cravings for crap will come back, but I'm hoping that keeping on the maintenance dose will mean that hunger and those cravings won't be as overwhelming as they were for the past 48 years! I also understand that I will put a little weight back on, but that's nothing to panic about and should settle down.

Ideally, my long term goal is to go down to 2.5mg for maintenance. At that stage the oral GLP1 pill might be out, and I might decide to switch to that. Or I may decide to switch to Wegovy for maintenance, if it is still better value than MJ. This is of course assuming both alternative medications work as well as MJ for maintenance.

With all the new research coming out about the benefits of GLP1s on inflammation and prevention of dementia/Alzheimers, I have no real urge to come off the medication entirely. I'm definitely more focused on protein and fibre now, so I do think that I have made some beneficial permanent changes to my diet, but likely not enough to come off GLP1s entirely and maintain the weight loss through diet and exercise alone.

I'll continue to post here and keep ye all up to date on progress.

The reason why myBMI have a large consultation fee and low fee for the actual pen is because they're aware that many of their customers have day-to-day health insurance where you can get varying amounts of fees back for GP costs, which the myBMI consultation fee counts as. This can be anything from €25 per appointment for a max of six appointments a year, up to 75% of the GP fee back for a higher number of appointments.

Just to note, it appears Laya won't cover myBMI GP costs, but Irish Life and VHI do.

This brings down the monthly cost significantly if you have this type of insurance.

In fairness to myBMI, their pricing structure really does benefit their customers. An actual bit of thought went into it.

That said, I don't particularly the whole model of online pharmacy subscriptions for private medicines. I think doctors and chemists should be separate. There's masses of profit to made through private prescriptions, especially in the UK where chemists mostly make a fixed fee from NHS prescriptions. Possibly that's why the online doctor/pharmacy hasn't really taken off here.

The whole "here's a discount code, get your friends to sign up" makes it more like TEMU and less like a doctor deciding on a serious medication to resolve a serious medical issue.