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David Brancaccio
job is it to make sure off brand weight loss compounds are up to snuff? David I'm David Brancaccio in Los Angeles. The Food and Drug Administration says it's preparing to reign 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 GLP1 drugs, Novo Nordisk of Denmark and Eli Lilly of Indiana. Originally the government allowed the off brand system to deal with the shortage. Marta Voshinska is a senior fellow in Economic Studies at the Brookings Institute center on Health Policy. She joins us now. Welcome.
Marta Voshinska
Good morning. Thank you so much for having me.
David Brancaccio
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. How have these compounders kept at it?
Marta Voshinska
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.
David Brancaccio
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 US they have incredible
Marta Voshinska
power of what products they allow through the border. They don't 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 that the landscape dramatically changed. You now have Novo and Eli Lilly participating with the Trump administration in these most favored nation agreements. Biden, they are on Trump Rx, they have now really leaned in, dropped their prices quite a bit. Now FDA 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.
David Brancaccio
Can Lilly or Novo, the big pharmas, can they meet demand?
Marta Voshinska
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.
David Brancaccio
But you've worried about standards or lack thereof in this whole area. What are some of your concerns?
Marta Voshinska
My concern was that the compounding pharmacies have been importing 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 PUR 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.
David Brancaccio
Marta Voshinska is a senior fellow in economic studies at the Brookings Institution's center on Health Policy. Thank you so much.
Marta Voshinska
Absolutely. Thank you for having me.
David Brancaccio
Also, just this week, Novo Nordisk announced it's cutting the list price for Ozempic, Wegovy and the oral diabetes drug Rybelsis by as much as half. But starting the first of next year, the company's stock is down 40% in a month. Eli Lilly stock is down just 3% during the same period. The Treasury Department says it will ease restrictions on Venezuelan oil exports to Cuba for 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. Foreign.
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David Brancaccio
payroll this Marketplace podcast is supported by Viking, committed to exploring the world in comfort. Journey through the heart of Europe on an elegant Viking longship with thoughtful service, destination focused dining and cultural enrichment on board and on shore. And every Viking voyage is all inclusive with no children and no casinos. Discover more@viking.com in just over a week, a new round of action in the Italian Alps. The Milan Cortina Paralympic Games kick off March 6. Dozens of athletes will represent the US 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.
Kimberly Adams
In addition to travel and equipment fees for time on the ice or the slopes. You have a private coach, you have
Marta Voshinska
a nutritionist, you have a strength and training conditioner. You have mental health professionals that assist.
Kimberly Adams
Lisa Noirotti teaches sports management at George Washington University and says with the extra pricey equipment for some winter activities, that
Marta Voshinska
takes up to 100,000 a year for some of these sports.
Kimberly Adams
Naradi 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.
Declan Farmer
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. You're only spending all your time off to go train and compete.
Kimberly Adams
Declan Farmer is a Paralympic gold medalist and plays sled hockey for Team usa.
Declan Farmer
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.
Kimberly Adams
Team USA has a fan supported nonprofit that does help fund athletes and a recent hundred million dollar donation is giving Paralympians and Olympians some retirement resources. But for most athletes striving along the way, it's the love of the sport that keeps them going, even if it costs them. I'm Kimberly Adams from Marketplace and the
David Brancaccio
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 has now bought turbines, jets and power plants. Marketplace Morning Report from APM American Public Media
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Episode: What it costs to become an Olympian or Paralympian
Date: February 26, 2026
Host: David Brancaccio
Reporter: Kimberly Adams
This episode of Marketplace Morning Report delves into the rising costs associated with becoming an Olympic or Paralympic athlete, particularly as the Milan Cortina Paralympic Games approach. The conversation exposes the financial hurdles faced by aspiring athletes—especially those in winter sports—and examines how this financial burden impacts not only their careers, but also the broader accessibility and diversity of elite athletic competition.
On regulatory loopholes and lack of standards:
“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 Voshinska (03:40)
On high annual athlete expenses:
“That takes up to 100,000 a year for some of these sports.”
— Lisa Noirotti (06:54)
On the impossibility of balancing work and training:
“Realistically, you can't just take time off from a standard job multiple times a month... You're only spending all your time off to go train and compete.”
— Declan Farmer (07:12)
On why athletes persist despite challenges:
“It's the love of the sport that keeps them going, even if it costs them.”
— Kimberly Adams (07:56)
This episode paints a vivid picture of the financial barriers that shape the dreams and realities of Olympic and Paralympic hopefuls. While some increased nonprofit support and donations offer hope, the overwhelming majority of athletes—especially those in high-cost winter sports—still face enormous personal and family sacrifices. The conversation underscores the need for broader support structures to ensure that athletic excellence isn’t reserved only for those who can afford it.