West Chester, Pennsylvania

Less Disparity in Obesity Care for Pennsylvania

The world works in mysterious ways. Five years ago, a group of us that included ConscienHealth’s Ted Kyle went to Harrisburg to testify in favor of Pennsylvania taking a step toward less disparity in obesity care. Specifically, we were supporting a bill that State Representative Donna Oberlander (R-Clarion) was sponsoring to encourage coverage of obesity medicines in the Pennsylvania Medical Assistance program. This is what the state calls its Medicaid program.

Five years later, that bill has passed in the PA House and it’s progressing toward passage in the Senate. But even better, it seems that all of the supportive buzz for this move has somehow led the state’s Pharmacy and Therapeutics (P&T) Committee to put every leading obesity med on its Statewide Preferred Drug List for 2023. The PDL is the list of drugs that Pennsylvania Medicaid will definitely cover. For 2023, that list includes Contrave, phentermine, Qsymia, Saxenda, and Wegovy.

“Please tell me my eyes do not deceive me!!!! Best news in weeks if that is true😊” wrote one specialist in obesity care when she spotted this change.

An Obsolete Attitude

Back in 2017 at that hearing, this change seemed unlikely to come from the state’s P&T committee. A pharmacist representing pharmacy programs for the state stepped up then to say that the department favored diet, exercise, and behavior change for treating obesity. She called it the “gold standard of care.” She described obesity meds as having little value because:

“Most patients regain weight when their weight-loss drugs are stopped.”

Our jaw dropped at that point. By such a standard, no one should be taking meds for blood pressure. Thankfully, that attitude has been become obsolete.

A Big Change in Just Five Years

This is a big change. Verlyn Warrington, an obesity medicine physician at the Guthrie Clinic in rural PA, worked for years to see this change:

“The world does work in mysterious ways. While we were pursuing the legislative angle, DHS was independently looking at anti-obesity medicines. A pediatric endocrinologist from CHOP and I gave some input regarding preferred meds and language around ongoing care. The result is that providers have quite a bit of latitude when compared to some of the restrictions imposed by some of the commercial insurance health plans.”

Chris Still, Director of the Geisinger Obesity Institute, told us:

“This is terrific news for a population that often could benefit the most from these medicines. Up until now they were excluded from PA Medicaid. But these patients deserve access to safe and effective obesity and metabolic treatment, including these drugs.”

UPMC obesity medicine physician Vicki March also worked for this change. She explains that this is an important step for a little less disparity in obesity care:

“Now I will be able to offer many of my patients – who currently have limited or zero access to these medications – the full array of care for obesity. Although this major change does not begin to repair the inequities in medical treatment that exist in our state, it is a crucial advance.”

Progress feels good.

Click here for the 2023 Statewide Preferred Drug List for the PA Department of Human Services.

West Chester, Pennsylvania, painting by Horace Pippin / WikiArt

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October 25, 2022