Snow Rifts Near the Seine

Will GLP-1 Medicines Widen the Economic Rift in Health?

Right now, the promise of GLP-1 medicines for obesity, though revolutionary, is serving only to widen the economic rift in health. People with extraordinary wealth or generous health insurance plans receive the health benefits that flow from treating obesity effectively – which include a longer life, fewer strokes, and fewer heart attacks. Others are consigned to receive second-class care.

Harvard’s Fatima Cody Stanford explains the problem.

“Currently, GLP-1 medications are widening the disparities that exist in care for persons with obesity and type 2 diabetes. Many of the communities that are disproportionally affected by these conditions are unable to access these medications. However, we can improve the status quo, and change the current landscape by recognizing these inequities and taking steps to address them.”

It is easier to deal with a problem if we recognize it. Writing in Nature Medicine, Stanford, along with Stephanie Waldrop and Veronica Johnson, outline the factors that contribute.

Solutions Everyone Can Elevate

For each of the contributors to the problem, Stanford, Waldrop, and Johnson offer solutions. But they go further. They describe how we can all lift them up.

Health professionals can obtain training to equip themselves to provide care that is free of bias and stigma. They can learn to address the complexity of obesity with competence to serve marginalized patients.

Patients can seek a better understanding of the chronic nature of obesity and prepare themselves for the marathon of overcoming obesity.

Insurers can do better to promote health and facilitate rational use of these medicines – rather than create irrational barriers to health and access to care.

Regulators can better align themselves with guidelines for chronic obesity care. Right now, they are often stuck on short-term end points and a weight-loss paradigm.

Drug makers can provide more leadership with long-term outcome data. They can do more to reach beyond wealthy and health-privileged populations – into communities where the unmet need is greatest.

The Right Path

Stanford et al conclude that we are on the right path for solving these problems:

“High list prices, variable insurance coverage and bias in prescribing, however, are all barriers to the equitable distribution of these medications. Health is a social good, and thus society has an obligation to provide health services that address the needs of all. GLP-1 agonists are effective treatments for weight management, and although regulatory bodies and medical providers are on the right path, we have a long way to go.”

Click here for their full commentary in Nature Medicine. For further perspective on wealth-based access to diabetes and obesity care, click here.

Snow Rifts Near the Seine, painting by Gustave Loiseau / WikiArt

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January 8, 2024