> Imagine two employees. One can afford these medications, the other cannot. One has regulated impulses, higher energy, better focus, and lower healthcare costs. The other doesn't. In a few years, data shows the first is three times more likely to be promoted.
> Scale that across society.
I'm not sure this is a reasonable worry. Ozempic is going out of patent in less than a year's time. There will be cheap generics all over the place. Purportedly the drug has a very low unit cost and uncomplicated manufacturing process, and every potential generic manufacturer knows it'll be a huge hit. That means we should expect it to rapidly become a commodity that's quite available.
If it really does cut food, alcohol, and cigarette costs so dramatically then I suspect a decent amount of poorer people would budget for the drug even if it didn't become cheap. It's not like poor people don't buy food, alcohol, or cigarettes today -- if it's a net savings and health/life improvement, it's even more worth buying than the alternative.