What it costs to become an Olympian or Paralympian

Whose job is it to make sure off-brand weight loss compounds are up to snuff? I'm David Brancaccio in Los Angeles. The Food and Drug Administration says it's preparing to rein in a key corner of the prescription weight loss drug market, compounding pharmacies and telehealth companies that mix together components and dispense lower cost versions of these medicines. These represent competition to the rights holders of GLP-1 drugs. Novo Nordisk of Denmark and Eli Lilly of Indiana. Originally, the government allowed the off-brand system to deal with a shortage. Marta Voschinska is a senior fellow in economic studies at the Brookings Institution's Center on Health Policy. She joins us now. Welcome. Good morning. Thank you so much for having me. I want to start with compounders. They were allowed to assemble these weight loss medicines because initially there was a shortage. But we covered this. Regulators some time ago declared the shortage over. However, how have these compounders kept at it? Compounding laws have a lot of loopholes. So if pharmacies were to customize the product, which is really how compounding is supposed to be done, they can continue compounding even though the drug is not in shortage. The issue is that the law doesn't sort of draw a line between the scale for compounding versus when it becomes commercial manufacturing. Now, I mean, the reason we're talking right is the FDA is saying it's going to try to curb some of this further. It will use, quote, all available compliance and enforcement tools. What kind of tools do drug regulators have in the U They have incredible power of what products they allow through the border They don have to see that there is an actual problem with the product They just need to suspect that there is a problem with the product My take on this is, is that the landscape dramatically changed. You now have Novo and Eli Lilly participating with the Trump administration in these most favorite nation agreements. They are on Trump Rx. They have now really leaned in, dropped their prices quite a bit. Now FGA has a lot more of an ability to now use those tools and protect those deals that they have basically made with these two manufacturers. Can Lilly or Novo, the big pharmas, can they meet demand? The fact that they're now shifting towards selling pills really makes a difference in terms of the ability to produce a lot of product quickly. Injectable products really have major bottlenecks in production. But you've worried about standards or lack thereof in this whole area. What are some of your concerns? My concern was that the compounding pharmacies have been importing a product that's basically where the company sets their own standards. They can decide what kinds of impurities they're going to test. They decide what is an appropriate level of impurities. They decide what is considered a pure product. That makes me very nervous that we don't have a set standard for these products and it's being used by millions of patients. Marta Woszynska is a senior fellow in economic studies at the Brookings Institution Center on Health Policy. Thank you so much. Absolutely. Thank you for having me. Also just this week Novo Nordisk announced it cutting the list price for Ozempic Wagovi and the oral diabetes drug Ribelsis by as much as half But starting the first of next year, the company's stock is down 40 percent in a month. Eli Lilly's stock is down just three percent during the same period. The Treasury Department says it will ease restrictions on Venezuelan oil exports to Cuba for, quote, commercial and humanitarian use, dialing down limits that are part of Cuba's worsening energy shortage. Electricity in Cuba comes from generators running on imported fuel. In just over a week, a new round of action in the Italian Alps. The Milan-Cortina Paralympic Games kickoff March the 6th. Dozens of athletes will represent the U.S. in sled hockey, skiing, wheelchair curling, and snowboarding. Among the business angles here is the fact that getting to the Paralympics and the Olympics is expensive. It costs competitors on average $12,000 a year. And as Marketplace's Kimberly Adams reports, for winter athletes in particular, costs can be even higher. In addition to travel and equipment, fees for time on the ice or the slopes, You have a private coach, you have a nutritionist, you have a strength and training conditioner, you have mental health professionals that assist. Lisa Narati teaches sports management at George Washington University and says with the extra pricey equipment for some winter activities. It takes up to a year for some of these sports Nirati says parents often eat most of the costs for younger athletes during the years of training it takes to get to the level of joining Team USA As for the adult athletes, all that training makes it hard to hold down steady work. Realistically, you can't just take time off from a standard job multiple times a month. And then, you know, best case scenario, you literally have no other time off. if you're only spending all your time off to go train and compete. Declan Farmer is a Paralympic gold medalist and plays sled hockey for Team USA. You know, we've had some great sled hockey players retire in their mid-20s over the years because they just simply, you know, can't make it work financially. Team USA has a fan-supported nonprofit that does help fund athletes, and a recent $100 million donation is giving Paralympians and Olympians some retirement resources. But for most athletes driving along the way, it's the love of the sport that keeps them going, even if it costs them. I'm Kimberly Adams for Marketplace. And the stock price of Rolls-Royce is up 4.5% in London now, with profits up 40%. This isn't the 1% buying sweet new rides. Rolls the car, that company's been owned by BMW of Germany for about three decades. Rolls-Royce is now about turbines, jets, and power plants. Marketplace Morning Report from APM, American Public Media.