Key Points from Dr. Yoshihiko Suzuki's Request

1. Concerns Regarding the Society's Strict Measures

Dr. Suzuki expressed strong concern upon hearing that the society is considering expulsion measures against physicians who prescribe anti-obesity drugs such as Wegovy and Zepbound outside of insurance coverage. He pointed out that such harsh penalties merely obscure the fundamental problems within Japan's healthcare system.

2. Structural Problems in Japan's Healthcare System

- Rising medical costs due to a declining birthrate and aging population, straining national finances
- Deteriorating business environment for private hospitals, making it difficult to secure profits through insurance-covered treatments alone
- Worsening working conditions for physicians and declining motivation
- Out-of-pocket treatments function as one solution to these problems

3. Defending Specialists' Discretion and Patient Interests

Dr. Suzuki argues that diabetes specialists possess the deepest expertise regarding the efficacy and side effects of semaglutide and tirzepatide, enabling them to provide optimal care tailored to each patient's individual circumstances. He specifically highlights tirzepatide's high preventive efficacy, with a diabetes onset prevention rate exceeding 95%, criticizing the failure to utilize it as contrary to the academic society's mission of “diabetes prevention.”

4. Warning Against Healthcare Disparities

He expresses concern that the current situation could lead to a paradoxical outcome: cosmetic surgeons and dermatologists lacking drug expertise profit, while the number of truly knowledgeable diabetes specialists decreases, ultimately depriving patients of appropriate medical care.

Key Points from the Japanese Diabetes Society's Response
1. Denial of Membership Termination Measures
The Society clearly denied any consideration of measures to terminate the membership of members who prescribe off-label.
 
2. Current Usage Policy
For individuals with type 2 diabetes who are obese and at risk for cardiovascular or renal disease: Use of Ozempic® and Mounjaro® is possible, not restricted by the Optimal Use Guidelines (OUG).
For obese individuals without diabetes: Use of Zepbound® and Ugoobi® is not recommended.
3. Future Outlook 
The Society acknowledges the need to collaborate with industry to advance research regarding expanding insurance coverage for mildly obese individuals with high cardiometabolic risk and revising the OUG. 4. Clear Opposition to Cosmetic Use The Society has clearly stated that the use of tirzepatide and semaglutide for cosmetic purposes is unacceptable. It strongly criticizes online-only consultations in particular, stating they are “absolutely unacceptable” because they prevent the detection of side effects.