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Luxury vacation home co-ownership platform Pacaso is attempting to appeal to the masses, as it grows its business during a pricey and competitive phase of the housing market.
The company, which launched in 2020 with multimillion-dollar homes listed for co-ownership, is now introducing thousands more listings with share prices starting as low as $200,000.
Pacaso lists shares of vacation homes, generally an eighth but sometimes larger shares, and then facilitates the purchase, including financing if necessary.

Luxury vacation home co-ownership platform Pacaso is attempting to appeal to the masses, as it grows its business during a pricey and competitive phase of the housing market.
The company, which launched in 2020 with multimillion-dollar homes listed for co-ownership, is now introducing thousands more listings with share prices starting as low as $200,000. Previously, shares had been closer to half a million dollars, or higher.

Pacaso lists shares of vacation homes, generally an eighth but sometimes larger shares, and then facilitates the purchase, including financing if necessary. It also furnishes and manages the home, divvying up the owners’ time in the home through an app. It takes fees for both the purchase and the management.
“You can afford a lot more home when you buy one eighth or one quarter of it when compared to purchasing the whole thing, and we’re living in an environment right now where housing affordability is a problem,” said Austin Allison, co-founder and CEO of Pacaso. “Home prices are high, interest rates are high, so it’s really difficult for people to afford the home of their dreams.”
Unlike timeshares in resorts, where consumers buy the time, not the property, Pacaso owners can benefit from the home’s value, which usually goes up over time.

An example of Pacaso’s new lower-priced vacation home listings.

“Our owners who have resold have benefited from about 10% appreciation above and beyond what they paid for the underlying home previously. So the Pacaso shares generally track with the underlying real estate,” said Allison.
Wealthier buyers have been scooping up ski homes in Colorado and beach homes in Hawaii, paying hundreds of thousands of dollars for their shares. Pacaso takes a hefty fee — between 10% and 15% of the value of the home on the front end — associated with aggregating the group of owners, facilitating the transaction, and setting up the co-ownership structure.

Pacaso reached more than $1 billion in revenue last year, the company said.
The company has, however, seen some backlash from communities that liken it to an Airbnb on steroids. There is even a website dedicated to fighting the company, called “Stop Pacaso Now.”
Residents of Sonoma, California, passed an ordinance prohibiting Pacaso from operating in that city. In St. Helena, California, which prohibits timeshares, Pacaso reached a settlement that protects its four homes already there, but the company is not allowed to expand to other properties.
“We operate in more than 40 markets nationwide and in only a handful are we misunderstood,” argued Allison. “Our approach is to work with policymakers and educate them on the facts and benefits. Our belief is that over time this will prevail. It hasn’t worked in Sonoma yet and a small handful of communities who have passed ordinances to resist the model.”
Pacaso is also adding a new suite of services to help primary homebuyers access the home-sharing model. Roughly one-fifth of primary homebuyers last year purchased with either a friend or relative, according to real estate site Zillow.
“People are now using co-ownership as a way to be able to afford houses that they otherwise wouldn’t be able to afford. So, it’s not just happening in the vacation home space,” said Allison.

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AN ANONYMOUS MEMO briefly circled the web in March. The authors, who claimed to be former partners at McKinsey, rebuked the illustrious strategy consultancy for its pursuit in recent years of “unchecked and unmanaged growth”, and chastised its leadership for, of all things, a “lack of strategic focus”. With humility typical of McKinseyites, they warned that “an organisation of genuine greatness” was at risk of being lost.The memo, which was swiftly taken down, is but the latest murmur of discontent at McKinsey. In January Bob Sternfels, its managing partner, was forced into an internal contest for the top job after he failed to clinch support for re-election from a majority of senior partners in an initial round of voting. Although he ultimately prevailed, the saga hinted at the trouble brewing within the firm.Chart: The EconomistNot long ago the consulting industry looked indestructible. Fees rocketed during the covid-19 pandemic as clients sped up efforts to digitise their businesses, diversify their supply chains and respond to growing calls to bolster their environmental, social and governance (ESG) credentials. The consulting revenues of the industry’s most important firms—including the triumvirate of strategy advisers (Bain, BCG and McKinsey), the “big four” accounting giants (Deloitte, EY, KPMG and PwC) and Accenture (also the world’s largest outsourcer)—grew by 20% in 2021 and then 13% in 2022 (see chart).Since then, however, growth has been soggy for this “great eight”, slowing to around 5% in 2023, according to estimates from Kennedy Research Reports, an industry-watcher, and calculations by The Economist, based on company filings. Clients grappling with inflation and economic uncertainty have cut back on splashy projects. A dearth of mergers and acquisitions has led to a slump in demand for support with due diligence and company integrations.That has caused a headache for the consultancies. When demand from clients looked limitless, they recruited staff like there was no tomorrow. Revenues at McKinsey are up by a third since 2019—but headcount is up by half, to 45,000. As job opportunities at startups and private-equity firms have withered, fewer consultants have left the firms of their own accord, reversing the spike in attrition rates during the pandemic.Now tomorrow is here, with a vengeance. Bain and Deloitte have paid some graduates to delay their start dates. Newbie consultants at some firms complain that there is too little work to go around, stunting their career prospects. Lay-offs have become widespread. All of the big four have made cuts to their advisory teams. Last year Accenture, the only one of the eight that is publicly listed, said it would fire 19,000 staff. On March 21st it reported that its consulting revenues for the quarter to February shrunk by 3%, year on year, after flattening in the previous quarter.The consulting industry has made it through choppy waters before, including during the dotcom crash and the global financial crisis. Yet its recovery this time will be complicated by three issues. The first is geopolitics. The consulting giants, all of which are based in the West, have benefited from decades of globalisation during which they spread their tendrils into every corner of the globe. Deloitte, the biggest of the bunch by consulting revenues, has offices in more than 150 countries and territories.That is now placing the firms in awkward spots. Last month it surfaced that the Urban China Initiative, a think-tank co-founded by McKinsey, provided advice to the Chinese government in 2015 that helped shape its “Made in China 2025” plan, which has sought to reduce the economy’s reliance on foreign know-how and place China at the forefront of sectors from electric vehicles to artificial intelligence. Although McKinsey denied that it wrote the report, some American lawmakers have called for the firm to be barred from American government contracts. In the 12 months to September 2023 the federal government paid McKinsey more than $100m in fees.Now China is also starting to squeeze foreign advisers out of its market. Last year Dentons, a global law firm, unwound its tie-up with Dacheng, a Chinese one, in response to new cybersecurity and data-protection rules that made the combination unworkable. Although China is yet to produce a homegrown consulting powerhouse, it has already begun to make life difficult for foreign ones. Staff in Bain’s Shanghai office were questioned by Chinese authorities a year ago, for reasons unknown. On March 22nd it was reported that the Chinese government was scrutinising PwC’s auditing work at Evergrande, a bankrupt Chinese property developer that has been accused of fraudulently inflating its revenues. That could weigh on PwC’s consulting business in the country.It is not only the West’s relationship with China that is causing problems. In February the bosses of BCG, McKinsey and Teneo, a smaller consultancy, along with Michael Klein, a dealmaker, were hauled before a congressional committee in Washington after failing to hand over details of their work for Saudi Arabia’s Public Investment Fund. The committee is investigating Saudi Arabia’s efforts to build “soft power” in America through, for example, its investments in sports such as golf. McKinsey and BCG said that their staff in Saudi Arabia could be imprisoned if they divulged details of their work for the country’s sovereign wealth fund. The Persian Gulf has been a rare bright spot for the consultants of late, with the oil-rich states splashing out on advice as they seek to diversify their economies.Waning enthusiasm for ESG, denounced by critics as “woke capitalism”, presents a second threat to the industry’s recovery. In recent years the consulting giants have spent big on building out their ESG offerings, especially around decarbonisation. In 2021 McKinsey acquired three sustainability consultancies. In 2022 Accenture gobbled up five. So far these investments seem to be paying off. Christoph Schweizer, the boss of BCG, which acquired the environmental consultancy Quantis in 2022, says that sustainability was one of his firm’s fastest-growing areas of work last year.Whether that growth will continue at the same pace is less clear. In America Republican-run states including Florida and Texas have withdrawn funds parked with BlackRock, the world’s largest asset manager, in protest over its use of ESG considerations when making investments. Consulting clients surveyed in January by Source Global Research, another industry analyst, ranked sustainability projects tenth in their list of priorities for the year, down from fourth in 2023. Some consulting grandees admit that certain clients are reining in their climate ambitions. According to one, that is in part because their customers are proving more resistant to paying the resulting premium.The third and thorniest challenge that lies ahead for the great eight is technological change. For many years clients sought their help to modernise creaky old systems. Increasingly, the consultants themselves are grappling with digital disruption. The boss of a big buy-out firm says that his dealmakers are turning to software tools and data providers rather than pricey consultants for some of the analysis needed to evaluate a target company. Other tasks that legions of consultants once spent hours on, like compiling and categorising data on a company’s spending habits, can now be done at the push of a button.The consultants are not standing idle. Bain, for example, has redesigned the way it does due diligence on companies, incorporating nifty tools such as web-scraping programs. The firms are also racing to stay one step ahead of artificial intelligence (AI). Last August McKinsey launched Lilli, a ChatGPT-like bot trained on its corpus of frameworks and other intellectual property, which consultants can use to speed up their work. Others have followed suit.Excitement among clients over such “generative” AI is also creating opportunities for the consultants. Mr Schweizer says that BCG has already completed hundreds of projects with clients around the technology. Accenture has booked $1.1bn worth of generative-AI work in the past six months. Much of this is happening in collaboration with the tech companies developing the AIs. Accenture has been working with Microsoft. In March the consulting firm also announced a partnership with Cohere, an AI-model builder with which McKinsey has buddied up, too. Bain has an alliance with OpenAI, the maker of ChatGPT. BCG has a collaboration with Anthropic, one more AI firm.Such partnerships look like a welcome source of growth for the consultants. In time, though, they could become a drag—especially if they are successful. The quicker corporate clients become comfortable with chatbots, the faster they may simply go directly to their makers in Silicon Valley. If that happens, the great eight’s short-term gains from AI could lead them towards irrelevance. That is something for all the strategy brains to stew on. ■ More

Chart: The EconomistThe blowout of a fuselage panel from a Boeing 737 MAX over Oregon in January was a “watershed moment” for its maker, according to Dave Calhoun. But it was only the latest in a string of incidents that have brought the once high-flying aerospace giant low. After trying—and failing—to right the company over the past four years, on March 25th Mr Calhoun said he would step down as chief executive at the end of 2024. His as-yet-unannounced successor will take the yoke in the middle of a turbulent flight. More

Boeing CEO Dave Calhoun will step down at the end of 2024 in part of a broad management shakeup for the embattled aerospace giant.
Chairman of the board Larry Kellner is also resigning and will leave the board at Boeing’s annual meeting in May.
Stan Deal, president and CEO of Boeing Commercial Airplanes, is leaving the company effective immediately.

Boeing CEO Dave Calhoun speaks to reporters as he departs from a meeting at the office of Sen. Mark Warner (D-VA) on Capitol Hill January 24, 2024 in Washington, DC. 
Anna Moneymaker | Getty Images

Boeing CEO Dave Calhoun will step down at the end of 2024 in part of a broad management shakeup for the embattled aerospace giant.
Chairman of the board Larry Kellner is also resigning and will leave the board at Boeing’s annual meeting in May. He has been replaced as chair by Steve Mollenkopf, who has been a Boeing director since 2020.

And Stan Deal, president and CEO of Boeing Commercial Airplanes, is leaving the company effective immediately. Moving into his job is Stephanie Pope, who recently became Boeing’s Chief Operating Officer after previously running Boeing Global Services.
The departures come as airlines and regulators have been increasing calls for major changes at the company after a host of quality and manufacturing flaws on Boeing planes. Scrutiny intensified after a Jan. 5 accident, when a door plug blew out of a nearly new Boeing 737 Max 9, minutes into an Alaska Airlines flight.
“As you all know, the Alaska Airlines Flight 1282 accident was a watershed moment for Boeing,” Calhoun wrote to employees on Monday. “We must continue to respond to this accident with humility and complete transparency. We also must inculcate a total commitment to safety and quality at every level of our company.
“The eyes of the world are on us, and I know we will come through this moment a better company, building on all the learnings we accumulated as we worked together to rebuild Boeing over the last number of years,” he wrote.
Last week, airline CEOs started scheduling meetings with Boeing directors to voice their displeasure at the lack of manufacturing quality controls and lower than expected production of 737 Max planes. The meetings were to include Kellner and one or more other board members.

Calhoun for months has promised investors, airline customers and the general public that Boeing will get its myriad quality struggles under control.
Calhoun was appointed to the top job in late 2019 and took the helm at Boeing in early 2020 after the company ousted its previous chief executive, Dennis Muilenburg, for his handling of the aftermath of two deadly 737 Max crashes.
Boeing’s stock was up more than 3% in premarket trading on Monday after Calhoun’s announcement.
This is breaking news. Check back for updates. More

Nelson Peltz’s Trian Management withheld its votes from Walt Disney CEO Bob Iger when voting its shares in the bitter proxy battle the asset management firm is waging against the entertainment giant.
Withholding its votes from Iger is hardly a supportive move of his leadership, and it raises questions about how toxic of an environment the boardroom would be if Peltz is elected to the Disney board next month.
The Disney board meeting will be held on April 3, and Trian could change its vote between now and then.

Nelson Peltz, founder and chief executive officer of Trian Fund Management, during the Future Investment Initiative (FII) Institute Priority Summit in Miami, Florida, US, on Thursday, March 30, 2023.
Marco Bello | Bloomberg | Getty Images

Nelson Peltz’s Trian Management withheld its votes from Walt Disney CEO Bob Iger when voting its shares in the bitter proxy battle the asset management firm is waging against the entertainment giant, according to sources who monitor the situation.
The move is hardly shocking, given the acrimonious nature of the battle.

However, it is counter to Trian’s proxy recommendations, and it doesn’t mesh with the public statements Peltz has made about wanting to work together with management if he is elected to the Disney board.
In recent weeks, Disney has stepped up its attacks on Trian and Peltz. “Correcting Trian’s Fact With Fiction” was the headline of a recent investor presentation from Disney, over a picture of Pinocchio with a growing nose.
“Disney is stupid because I’m not trying to fire Bob Iger, I want to help him,” Peltz recently told The Financial Times. “We don’t fire CEOs.”
Withholding its votes from Iger, however, is hardly a supportive move of his leadership, and it raises questions about how toxic of an environment the boardroom would be if Peltz is elected to the Disney board next month.
Disney has nominated a slate of twelve directors, including Iger. Trian is officially recommending shareholders vote for Peltz and former Disney Chief Financial Officer Jay Rasulo and to withhold votes for Disney nominees Maria Elena Lagomasino and Michael Froman, who are current board members.

Trian owns a relatively small position in Disney, representing about 1.5% of the outstanding shares when combined with the ownership position of former Marvel Entertainment Chairman and CEO Ike Perlmutter, who has sided with Peltz in the proxy battle. Trian did not immediately respond to CNBC’s request for comment.
The Disney board meeting will be held on April 3 and Trian could change its vote between now and then. More

Amgen is among a crowded field of drugmakers racing to develop the next blockbuster weight loss drug — but it’s taking an entirely different approach than its rivals.
The biotech company is testing a monthly injection that works differently from Wegovy and Zepbound and appears to help patients maintain their weight loss even after they stop taking it.
Still, more data is needed to see how competitive Amgen will be in the obesity market.

The Amgen logo is displayed outside Amgen headquarters on May 17, 2023 in Thousand Oaks, California.
Mario Tama | Getty Images

Amgen is taking a new approach as it tries to stand out in a crowded field of drugmakers racing to develop the next blockbuster weight loss drug.
The biotech company is testing an injectable treatment that helps people lose weight differently from the existing injections from Novo Nordisk and Eli Lilly, and other obesity medicines in development. Amgen’s treatment, called MariTide, also appears to help patients keep weight off after they stop taking it.  

The drugmaker is also testing its drug to be taken once a month or even less frequently, which could offer more convenience than the weekly medicines on the market. 
It’s too early to say how competitive Amgen will be in the budding weight loss drug space, which Novo Nordisk and Eli Lilly have so far dominated.
Some analysts expect the market could be worth $100 billion by the end of the decade, potentially leaving room for new competitors to enter. Goldman Sachs also projects that between 10 million and 70 million Americans will be taking weight loss drugs by 2028.
The available data on Amgen’s injectable drug is promising, but it’s from a small, early-stage clinical trial. The Thousand Oaks, California-based company also is developing an oral medicine and other treatments for obesity, but has disclosed few details about them. 
Investors and health experts will likely get a better idea of Amgen’s prospects later this year: The drugmaker expects to release initial data from an ongoing mid-stage trial on MariTide, along with phase one data on its obesity pill. 

It’s also unclear whether Amgen’s treatments will be cheaper than the existing weight loss drugs, which cost around $1,000 per month.
Wegovy from Novo Nordisk and Zepbound from Eli Lilly lead a new class of obesity treatments that has drawn unrelenting patient demand — and investor interest — despite their hefty price tags and limited insurance coverage. 
Eli Lilly and Novo Nordisk have also struggled to offer enough supply of their treatments, which could give other companies a chance to win market share.  

How Amgen’s treatment is different

Amgen’s drug offers a new twist on weight loss. 
Much like Wegovy and Zepbound, one part of Amgen’s treatment activates a gut hormone receptor called GLP-1 to help regulate a person’s appetite. 
But while Zepbound activates a second hormone receptor called GIP, Amgen’s drug blocks it. Wegovy does not target GIP, which suppresses appetite like GLP-1 but may also improve how the body breaks down sugar and fat.
Amgen’s decision to tamp down rather than boost GIP activity is based on genetics research suggesting that blocking the receptor is linked to lower fat mass and body weight, company executives have said. 

Some approved and experimental weight loss drugs

Wegovy from Novo Nordisk: Approved weekly injection that activates GLP-1
Zepbound from Eli Lilly: Approved weekly injection that activates GLP-1 and GIP
Saxenda from Novo Nordisk: Approved weekly injection that activates GLP-1
MariTide from Amgen: Experimental monthly injection that activates GLP-1 and blocks GIP
Danuglipron from Pfizer: Experimental once-daily pill that activates GLP-1
VK2735 from Viking Therapeutics: Experimental weekly injection that activates GLP-1 and GIP
Pemvidutide from Altimmune: Experimental weekly injection that activates GLP-1 and another gut hormone called glucagon
GSBR-1290 from Structure Therapeutics: Experimental weekly pill that activates GLP-1
Survodutide from Zealand Pharma, Boehringer Ingelheim: Experimental weekly injection that activates GLP-1 and glucagon

That appears to contradict how Zepbound works. Eli Lilly’s approach has proven successful: The treatment helped patients with obesity lose up to 22.5% of their weight after 72 weeks in a late-stage trial.
But Amgen’s MartiTide also was effective in a small, early-stage study. 
Patients given the highest dose of Amgen’s drug — 420 milligrams — every month lost 14.5% of their body weight on average in just 12 weeks, according to data from the phase one trial published last month in the journal Nature Metabolism. 
There’s a broader debate among researchers about why both approaches – blocking and activating GIP – are effective at promoting weight loss. 
One theory is that repeatedly activating the GIP receptor, as Zepbound does, ultimately causes the body to “self-regulate” itself and make sure there isn’t too much GIP activity, said Dr. Caroline Apovian, a director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital.
That decreases GIP activity overall, which is thought to essentially mimic what Amgen’s drug achieves when it blocks the GIP receptor. But Apovian cautioned that “none of this is proven” and more data is needed.

The drug could result in longer-lasting weight loss

Amgen’s treatment may be better at helping people maintain weight loss than competitors, even though patients take it less frequently, early-stage trial data suggests.
Amgen’s study enrolled 110 patients with obesity but not diabetes. Patients in one group were randomly assigned to receive a single dose of the drug and were followed for 150 days, while a second group was given a dose every four weeks for three months. 

An obesity patient takes a injection of weight loss medication.
Joe Buglewicz | The Washington Post | Getty Images

Patients who received a single shot of the highest dose of MariTide lost up to 8.2% of their body weight after 92 days. That suggests a single injection of the drug has a prolonged weight loss effect, according to the study authors. 
In the group that received multiple doses of the drug, patients appeared to maintain their maximum weight loss until around two months after their last dose. Their body weight started to slowly return after that. Still, their weight was as much as 11.2% lower five months after they received the last dose. 
“We think meaningful weight loss is already 5%. If you take Amgen’s drug, lose 14.5%, stop the drug and still have 11.2% weight loss after a few months, that’s significant,” said Dr. Holly Lofton, director of the Weight Management Program at NYU Langone Health and an obesity medicine physician. But she pointed out the need to study the treatment in a larger group of people. 
The sustained weight loss in Amgen’s study appears to contrast with results seen in clinical trials on Zepbound and Wegovy. Patients in those studies saw their weight rebound sooner after stopping the injections. 

Once a month or even less frequent dosing 

The frequency of Amgen’s drug also sets it apart. Those on Wegovy or Zepbound have to take doses weekly, compared with the once-monthly MariTide. 
Amgen’s trial used monthly dosing in part because patients saw sustained weight loss whether they had a single injection or multiple shots of the company’s drug, according to the study authors. 
Amgen’s treatment also can stay in the body for much longer than current therapies like Wegovy and Zepbound because it includes a monoclonal antibody, the authors added. 

An injection pen of Zepbound, Eli Lilly’s weight loss drug, is displayed in New York City, U.S., December 11, 2023. 
Brendan McDermid | Reuters

Amgen’s MariTide “has that advantage where it’s just going to last a lot longer. Even if you give a high dose, you’re still going to have drug exposure in the body for a month or two months, so that clearly shows you don’t need to take it every week,” William Blair & Company analyst Matt Phipps told CNBC.
Phipps said people typically don’t want to get injections often, so some patients could prefer a monthly shot like Amgen’s MariTide for a disease that will likely require chronic treatment. 
But he noted that a patient’s choice may also depend on whether the level of weight loss and side effects of Amgen’s drug end up being on par with those of the existing weekly injections. 
Amgen’s ongoing phase two trial is exploring whether patients can take its drug even less frequently than once a month. 

Phase two trial will bring more clarity

Amgen’s longer-term phase two study on nearly 600 patients will provide more clarity on how competitive MariTide will be against Wegovy and Zepbound. The company is exploring which dose strength and schedule is best for patients. It expects to release initial trial results later this year. 
Some analysts have said the phase two trial could help address several questions, including how well patients tolerate the treatment at different dose regimens.
The 52-week study is testing 11 different patient groups at a variety of dosing levels and regimens. That includes starting some patients at a lower dose of a drug and gradually increasing it until they reach a higher target dose. 
That dose escalation could help reduce side effects that some patients experienced after taking their first dose of MariTide in the phase one trial, according to Phipps.
In that trial, the safety and side effects of Amgen’s drug were similar to other GLP-1 medications. Nausea and vomiting were the most commonly reported side effects, and typically lasted for about 72 hours. 
Four out of eight patients in a group receiving the highest dose of the treatment withdrew before getting a second shot due to mild gastrointestinal issues, according to the study. But no other patients stopped taking the drug due to adverse events across any of the different dosing groups, Amgen Chief Medical Officer Paul Burton said during a conference earlier this month. 
“It’s a little early to jump to the conclusion that the drug won’t be tolerated by patients based on this phase one data,” William Blair & Company’s Phipps said.
Another part of Amgen’s phase two trial will also examine weight loss beyond 52 weeks, which will provide a clearer picture of how long the drug is effective.

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Americans can’t seem to get enough of weight loss drugs despite their limited insurance coverage and roughly $1,000 monthly price tags before discounts. 
But some patients are willing to pay more out of pocket for those treatments than others — and it’s strongly correlated to their annual income.
That’s according to a recent survey from Evercore ISI that focused on GLP-1s, which include Novo Nordisk’s weight loss injection Wegovy and diabetes counterpart Ozempic.

Boxes of Wegovy made by Novo Nordisk are seen at a pharmacy in London, Britain March 8, 2024. 
Hollie Adams | Reuters

Demand for weight loss drugs is booming in the U.S. despite their limited insurance coverage and roughly $1,000 monthly price tags before discounts. 
But some patients are willing to pay more out of pocket for those treatments than others — and that desire is strongly correlated to their annual income.

That’s according to a recent survey from Evercore ISI focused on GLP-1s, a new class of medications used to treat Type 2 diabetes and obesity. Between Jan. 24 and Feb. 20, the firm surveyed more than 600 participants who are currently taking a GLP-1, considering the therapy or have taken it in the past but no longer do. 
The findings on how much patients are willing to spend underscore concerns about equity in access to the breakthrough drugs while insurance coverage is sparse.
GLP-1s include Novo Nordisk’s blockbuster weight loss injection Wegovy and diabetes counterpart Ozempic, along with Eli Lilly’s popular weight loss treatment Zepbound and diabetes injection Mounjaro. 
A monthly package of a GLP-1 costs between $900 and $1,350 before insurance and other rebates. Both Novo Nordisk and Eli Lilly have savings programs that aim to reduce out-of-pocket costs for weight loss drugs, regardless of whether a patient has commercial insurance coverage. 
The majority — nearly 60% — of people surveyed with annual incomes of more than $250,000 said the maximum price they are willing to pay out of pocket for a GLP-1 is more than $300 per month. 

Only about 4% of people with annual incomes of less than $75,000 said the same thing. Of that group, 64% said the maximum price they are willing to pay out of pocket for a GLP-1 is $50 per month or less. 

The maximum people currently on a GLP-1 said they are willing to pay out of pocket per month was roughly in line with what they actually paid for treatment, according to the survey. The highest price respondents would accept paying skewed lower among those who used to take a GLP-1 or are thinking of taking the drug. 
More than half of people currently taking a GLP-1 said they are paying a monthly price of $50 or less out of pocket. Nearly 75% of those who used to take one of the drugs said they spent the same amount. 
A small share of both groups paid more than $750 out of pocket per month for a GLP-1.

The survey also asked respondents how long they stayed on the drugs.
Notably, more than 80% of those who used to take a treatment were only on a therapy for 12 months or less. Some people stopped due to cost, while others stopped a treatment because they hit their weight loss goal or experienced side effects.
That premature stoppage by some patients is one concern of certain insurers hesitant to cover them.
Still, nearly half of people who are currently taking GLP-1s said they intend to stay on the drugs permanently. Only 10% of those thinking of taking a treatment said the same thing. Of that group, more than 70% said they intend to stay on a GLP-1 until they reach their weight loss goal.
The survey also asked participants whether they would restart taking a GLP-1 if they regain weight after stopping the drug. The majority of patients across all groups — those currently on a GLP-1, thinking of it, or who used to take one — said “yes.” 

Among those who used to take a GLP-1, 42% said they gained “some” weight back after stopping treatment. Around 13% said they gained most of it back, while 23% said they gained all of it back. Another 23% said they remained at a lower weight after stopping the drug.
That weight regain is consistent with what has been observed in some clinical trials on drugs such as Wegovy and Zepbound.
Another part of the survey asked participants about whether taking a GLP-1 affected their eating and drinking habits. 
More than 70% of respondents reporting eating less when taking a GLP-1, regardless of whether they have pre-existing conditions. That refers to other health problems, such as diabetes, asthma or high blood pressure.
The survey finding is no surprise: GLP-1s work by mimicking a hormone produced in the gut to suppress a person’s appetite and regulate blood sugar. Some treatments, such as Zepbound, mimic more than one gut hormone.

More than half of those without preexisting conditions said they drank less alcohol when taking a GLP-1. Around 27% said the treatment had no effect on their alcohol consumption, while 22% said they abstain from drinking. 
A greater share — 51% — of those with preexisting conditions said they abstain from alcohol. The remainder said they consumed less alcohol when taking a GLP-1. 
Several studies have demonstrated that certain GLP-1s curb alcohol intake in rodents and monkeys. But more research is needed in humans.

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— CNBC’s Gabriel Cortés contributed to this report More

New Biden administration standards for tailpipe emissions are expected to be a win for legacy automakers such as GM, Ford and Stellantis.
The new regulations come as adoption of electric vehicles in the U.S. has been slower than expected.
Tesla and environmental groups criticized the standards, which may be designed in part to help Biden with key constituencies in the presidential election.

President Joe Biden speaks at the United Auto Workers political convention at the Marriott Marquis in Washington, D.C., Jan. 24, 2024.
Saul Loeb | AFP | Getty Images

DETROIT — The Biden administration’s decision to ease its timeline for all-electric vehicle adoption and give automakers more ways to meet new tailpipe emissions standards is expected to be a win for legacy automakers.
The new Environmental Protection Agency rules released Wednesday aim to cut tailpipe emissions by 49% between model years 2027 and 2032. The EPA set a target for EVs to make up at least 35% of new vehicle sales by 2032.

The standards are less ambitious than proposed rules released last year, which targeted a 56% reduction in emissions by 2032 and called for EVs to represent 67% of new vehicles by that year.
The lower expectation for EV adoption comes amid slower-than-expected sales of the vehicles, which can cost tens of thousands of dollars more than their traditional gas counterparts.
The EPA’s new strategy for cutting tailpipe emissions doesn’t focus only on EVs. It took into account more efficient gasoline engines, hybrids and plug-in hybrid electric vehicles.
The EPA’s percentage targets for EV adoption are not mandates but expectations for how automakers could meet the emissions regulations. The target range for the share of EV sales in the market in 2032 is between 35% and 56%.
The EPA said the standards will avoid more than 7 billion tons of carbon emissions and provide nearly $100 billion of annual net benefits to society. It said those include $13 billion of annual public health benefits due to improved air quality, along with $62 billion in reduced annual fuel costs and maintenance and repair costs for drivers.

Here are some key takeaways about what the new guidelines mean for automakers, investors and the environment.

A win for Detroit

Automotive officials and Wall Street analysts are touting the altered rules as a major win for legacy automakers, specifically the traditional Detroit automakers General Motors, Ford Motor and Chrysler parent Stellantis, which largely rely on big SUVs and trucks to make profits.
“We view this development as positive for traditional US automakers, since the new rules put less pressure on them to ramp up EV production in the near term, and could even potentially enable them to reduce further EV capex and R&D,” Deutsche Bank analyst Emmanuel Rosner said Thursday in an investor note.

President Joe Biden, with General Motors CEO Mary Barra, looks at a Chevrolet Silverado electric vehicle as he tours the 2022 North American International Auto Show at Huntington Place Convention Center in Detroit, Michigan, on Sept. 14, 2022. Biden is visiting the auto show to highlight electric vehicle manufacturing.
Mandel Ngan | Afp | Getty Images

John Bozzella, president and CEO of the Alliance for Automotive Innovation, a lobbying group that represents most automakers in the U.S., agreed.
“Moderating the pace of EV adoption in 2027, 2028, 2029 and 2030 was the right call because it prioritizes more reasonable electrification targets in the next few (very critical) years of the EV transition,” he said.
The new rules also are a victory for the Detroit-based United Auto Workers union, which has raised concerns about how the transition from internal combustion engines to EVs could affect jobs.
“By taking seriously the concerns of workers and communities, the EPA has created a more feasible emissions rule that protects workers building [internal combustion engine] vehicles, while providing a path forward for automakers to implement the full range of automotive technologies to reduce emissions,” the UAW said in a statement.
Stocks for the Detroit automakers, as well as others such as U.S. hybrid leader Toyota Motor, closed higher Wednesday following the announcement.

Tesla, some green groups unhappy

While the new standards sparked relief in Detroit, others weren’t too pleased.
The new rule “falls far short of what is needed to protect public health and our planet. EPA is giving automakers a pass to continue producing polluting vehicles,” said Chelsea Hodgkins, senior policy advocate at left-leaning consumer rights group Public Citizen.
Martin Viecha, vice president of investor relations for the biggest U.S. EV maker, Tesla, agreed in a post on X: “Unfortunately, people use plug-in hybrids mainly as gas cars, which means their CO2 emissions are far worse than official EPA or WLTP ratings suggest.”
“Just like officially rated energy consumption of EVs has been getting closer and closer to reality, same should be done for plug-in hybrids,” he added.
Environmental group Sierra Club, which has condemned automakers such as Toyota for their reliance on hybrids, broke with past statements and hailed the standards. The organization, which endorsed President Joe Biden for reelection, said the new rules are “one of the most significant actions his administration can take on climate change.”

Political implications

Several experts and Wall Street analysts were quick to point out that the new standards could help Biden with some groups in his reelection campaign.
“We surmise this slight leniency appeases to lobbying on behalf of automakers — or more pointedly, the auto unions — which have understandably viewed the aggressive efforts (e.g., the IRA bill turned law) by the Biden administration to ‘electrify’ the auto industry as a threat to their jobs in conventional auto manufacturing plants,” Loop Capital analyst Chris Kapsch said in an investor note.
Morgan Stanley analyst Adam Jonas agreed in a separate note: “The delay and flexibility baked into the new timeline could be part of an effort to appease the UAW, a key Democratic constituency historically concerned about the rise of EVs.”
The move could help the president with the UAW, which endorsed Biden for reelection in January. It could also be designed to boost him in Michigan — home of GM, Ford and many other suppliers — which is expected to play a pivotal role as a swing state in this year’s presidential election.

Not over yet

The tailpipe emissions regulations are only one part of the federal government’s policies that aim to boost the efficiency of vehicles.
Automakers are still awaiting the “Corporate Average Fuel Economy,” or CAFE, standards from the National Highway Traffic Safety Administration, a part of the Department of Transportation, for 2027 to 2032 model-year vehicles.
CAFE standards set out to regulate how far vehicles must travel on a gallon of fuel. NHTSA in 2023 proposed an industry fleet-wide average of approximately 58 miles per gallon for passenger cars and light trucks in model year 2032, by increasing fuel economy by 2% per year for passenger cars and by 4% annually for light trucks.
The CAFE standards are expected to be finalized later this year.
There’s also the California Air Resources Board, which can set its own standards for emissions and fuel economy – a power former President Donald Trump attempted to take away.
For years, automakers such as GM have argued there should be one national standard for fuel economy and greenhouse gas emissions to help them plan and make it easier to comply.
“While we review the details, we encourage continued coordination across the U.S. federal government and with the California Air Resources Board to ensure the auto industry can successfully transition to electrification,” GM said in a statement.
— CNBC’s Michael Bloom contributed to this report.

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