Real Conversations About Obesity Med Costs?

Couples in ConversationPublic discourse about new medicines for treating obesity is easy to find right now – and a lot of it seems unreal from our vantage point. Headlines about people “terrified” by the prospect of effective options for kids with severe obesity or debating which Hollywood stars might be taking one of these drugs are weirdly off-topic. But in the midst of all this, it’s hard to find serious reporting on real conversations about obesity med costs.

So a new report on this subject by Karen Weintraub for USA Today is refreshing to see.

Excuses from Health Insurers

You might think that the people who have to pay the bills for this could be the source of a reality check. You would be wrong. Speaking for America’s Health Insurance Plans, Kristine Grow offers doubletalk that would make a propaganda officer proud. She told Axios that these remarkably effective new drugs:

“Have not yet been proven to work well for long-term weight management and can have complications and adverse impacts on patients.”

Back in the real world, people know that FDA is very cautious about drugs for obesity and that these new meds are changing the lives of people who have struggled unsuccessfully with obesity for years.

Of course, these are prescription drugs for a complex, chronic disease – not miracle cures. They have risks and benefits and they don’t work equally well for everyone. But they are vastly better than the limited options that came before them.

With all that said, pretending that these drugs won’t work very well is a lame excuse for AHIP to offer up on a serious subject that profoundly affects the lives of many Americans. It’s a lazy way to sidestep the real issue of obesity med costs.

The Uncomfortable Subject of Drug Costs

It is easier for everyone to avoid this subject because, frankly, the cost of drugs in the U.S. is royally messed up. The median annual price of a new drug in the U.S. has risen from $2,115 in 2008 to $180,007 in 2021. In the face of such cold, hard facts, arguing that drug prices are not out of control is also absurd.

So we can’t simply avoid the subject of obesity med costs. Because these drugs represent an important advance in treating a chronic disease where the unmet medical need is great. But, as ECRI CEO Marcus Schabacker told Weintraub for USA Today:

“It just doesn’t help if it is unaffordable to the majority of patients who need it.”

These meds are unaffordable for two reasons. First because the cost of new drugs in the U.S. is so high. New obesity meds are no exception. Second, because health insurers are trying to dodge responsibility for covering obesity. Prescription plans often exclude these meds or make it hard to know if they’ll be covered. ConscienHealth’s Ted Kyle explained to Weintraub:

“Coverage policies can be very confusing and thus lead people to give up on getting these medicines from their drug plans – even when they might be covered.”

In the end, it doesn’t matter if this conversation is uncomfortable. It’s necessary. These drugs meet an important medical need. People will come to expect access to better obesity care and neither health plans nor drug makers will escape responsibility for resolving these issues.

Click here for Weintraub’s reporting and here for further perspective from Axios.

Couples in Conversation, lithograph by Oskar Kokoschka / WikiArt

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February 20, 2023