Can Obesity Medicines Improve Population Health?
To open Obesity Medicine 2024 yesterday, David Arterburn presented a brilliant perspective on the radical paradigm shift and price wars that lie ahead in obesity care. Along the way, he explained how he believes that better obesity medicines can help meet a fundament goal of healthcare: to improve population health. He described the future of obesity care we are facing:
“This will be a very volatile period but the movement will clearly be in a very favorable direction.”
What will make this true? Mostly it will be a result of the emergence of an impressive body of health outcome data that fits into the context of real world utilization of the remarkable new drugs we have for obesity. Together with that, pressure for lower prices will make it possible to utilize them on a scale that can have a favorable impact on population health.
Five Aims for Obesity Care
Arterburn described improving population health as the first of five principle aims for obesity care. In order to achieve sufficient scale to improve population health, we will have to find strategies for reducing costs. Part of that will come from falling prices for the new generation of obesity medicines. Increased competition and generic alternatives will bring pressure for this. But that will take time. Until then, reducing costs will mainly be possible by targeting clinical subgroups who are most likely to benefit dramatically from better care.
He went on to explain that enhancing patient care experiences by reducing stigma in healthcare is essential. This is a challenge that extends well beyond the confines of obesity care. Because persons with obesity encounter bias in every aspect of healthcare and it undermines population health.
The final two aims in this list of the essential five are fostering care team wellbeing and improving health equity. Care team wellbeing can come from defining care pathways that are both feasible and that reduce burnout for clinicians. Health equity in obesity care is something that current systems of care are largely failing miserably – because obesity care goes mostly to the few and the wealthy. Clearly this requires a transformative effort.
We Can Do This
Arterburn sees outcomes data as a key to achieving many of these aims. He pointed to the quick CMS decision to open up Medicare coverage to obesity medicines in cardiovascular disease as evidence that policy makers can understand the potential of obesity medicines to improve population health – when outcome data emerges to support that understanding.
It will be a radical shift to start thinking of obesity care as a tool for improving population health. That means we’re in for a bumpy ride. But we have no doubt we will get there.
Click here for Arterburn’s outstanding presentation, which offers much more insight than this short post can provide.
People Strolling, painting by Vincent van Gogh / WikiArt
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April 27, 2024
