Surprise! People Keep Taking Obesity Meds That Work

SurprisedIt is mildly entertaining to watch people squirm as new obesity medicines disrupt their presumptions about obesity and its treatment. Of course, this squirming comes in many different forms. One expression of it is dismay that many people don’t keep taking obesity meds after a year. “Until compliance for these medications increases,” we’re not going to pay for people to keep taking them, said the University of Texas earlier this year.

Setting that disjointed thinking aside, a new study in Obesity says that, actually, compliance with these new obesity medicines is much better compared with the older medicines in this category.

Effectiveness and Insurance

Hamlet Gasoyan and colleagues found that people taking semaglutide for obesity were four times more likely to keep taking it after a year than people receiving prescriptions for older obesity meds. They report that effectiveness and insurance are key factors:

“Patients receiving the newer, more effective forms of AOM and those experiencing greater medium-term weight loss are more likely to persist. Among privately insured individuals, there is also significant variation in AOM persistence based on insurance carrier.”

Are we surprised that insurers can succeed in causing people to stop these medicines? Nope. Not at all. Withdrawal of coverage for expensive and effective medicines forces people to make hard choices between paying the bills and protecting their health.

Making Wealth a Prerequisite for Health

Gasoyan et al indirectly documented disparities in access to these medicines. Mostly wealthier White women are in a position to persistently take semaglutide. Living in an economically deprived area or relying on Medicaid for health insurance meant that a patient was unlikely to receive a prescription for an advanced obesity medicine. Most of the patients in this study were White (76%) and women (75%). Because these are the people who are getting prescriptions for obesity medicines.

Right now, given the pricing of highly effective obesity medicines and variability in coverage, disparities in the effects of obesity on health are likely to grow. Wealth should not be a prerequisite for health.

Click here for the new study, here and here for reporting on it.

Surprised, illustration by Charles Robinson / WikiArt

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December 7, 2023