Searching for Value in Obesity Treatment
What’s the value of innovation in obesity treatment?
An unusually diverse group of stakeholders gathered at the Center for Medical Technology Policy (CMTP) to define some shared views about value in obesity treatment Monday. Patient advocates, private health plans, scientific organizations, regulators, government health plans, and medical technology innovators were all represented.
Policies that confront people seeking treatment for obesity are inconsistent at best. Wellness programs that impose weight goals are routinely paired with health plans that exclude coverage for evidence-based obesity treatment. People have too few options and when such options exist, they are hidden behind policies that limit access — even though utilization is ridiculously low.
Illustrating this point, Chief Medical Officer Sylvia Lopez of the Oklahoma Medicaid Program explained that their program never covered bariatric surgery for any patients until ordered to do so by an administrative law judge. And even so, the program now has so many limitations that it is seldom utilized.
And from there a lively discussion followed on how to develop a rational process for decision making about paying for new technology to treat obesity.
In an interview for the Washington Post, Obesity Society Policy Advisor Ted Kyle pointed out that reimbursement policies are not keeping up with broad recognition that obesity is a complex, chronic disease. He said “people still assume that obesity is simply a matter of bad choices. But the fact is that better than half of the risk of obesity is inherited.”
Said Caroline Apovian, Director of the Nutrition and Weight Management Research Center at Boston University, “Coverage has to happen in order for the obesity problem to be taken care of. Insurance companies need to realize it’s not a matter of willpower, it’s a disease.”
Innovation to address the vast unmet medical need for better obesity treatment has little value if it’s out of reach for most people with health insurance.
Lowest Prices EVER! photograph © Stephen Grebinski / flickr
Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.