Posts Tagged ‘health insurance’

Profiteering and the Criminal Trade in Bogus Obesity Medicines

December 15, 2025 — Business is apparently booming in the criminal trade for bogus obesity medicines. The Times (London) reports that criminals are selling dangerous weight-loss jabs on social media and in gyms. They write that: “Pharmaceutical bosses have issued a stark warning about medicines such as Mounjaro sold online without safety controls as gangs branch out from hard […]

Striking Growth of GLP-1s in Women with PCOS

December 14, 2025 — Truveta this week published data that reveals striking growth in the use of GLP-1s by women with PCOS (polycystic ovary syndrome). Prescriptions for semaglutide or tirzepatide have risen by more than 700% in women with PCOS, according to their analysis. So don’t think that this is slipping right by the bean counters at drug benefit […]

ADA, OAC, and TOS Collaborate on Models for Obesity Care

November 4, 2025 — It was remarkable and much needed. On the pre-convention day for ObesityWeek in Atlanta, ADA, OAC, and TOS began work to collaborate on models for obesity care that will begin to deliver on a scale that matches the urgency and scope of unmet medical need. TOS Vice-President Jonathan Purnell described the urgency of this to […]

The New GLP-1 Shortage: Insurance Coverage and Access

November 3, 2025 — A year ago, we had these wonderful new obesity medicines – semaglutide and tirzepatide – and nobody could get them. Demand had outstripped supply and we had a shortage. Earlier this year, the supply shortage for both drugs resolved, but now we face the same situation because of a different shortage. There is a shortage […]

Medicare Out-of-Pocket Costs Double for GLP-1s in 2025

September 28, 2025 — Back in March 2024, we welcomed the news of a door opening ever so slightly for Medicare Part D plans to cover GLP-1s in people with obesity and heart disease. So 18 months later, it’s reasonable to ask, how’s that working out for everyone? A new research letter in JAMA gives us an answer, but […]

Is a Door Opening for Obesity Medicines in Medicare?

August 2, 2025 — When the new administration announced in April that it would not be implementing expanded access to obesity medicines in Medicare, they suggested this would not be the final word. Yesterday, we got a hint of what might come. Paige Winfield Cunningham reported in the Washington Post that CMS has drafted a plan to allow Medicare […]

The Rocky Path from Weight Loss to Obesity Care

June 12, 2025 — It is undeniable that obesity is a complex, chronic disease. When we gather people from all over the world who understand obesity, this is the number one thing everyone can agree upon. And yet, when we sit down to talk about models for health systems delivering obesity care, it is more likely that folks who […]

Surprise! GLP-1s Don’t Have to Blow the Bank for a Health Plan

May 29, 2025 — A new analysis from Milliman has a revelation for health plan managers complaining loudly about the burdensome costs of GLP-1s blowing up their budgets. They’re doing it wrong. Expenses for GLP-1s that can dramatically improve the health of persons with obesity simply do not have to break the bank for a health plan. In fact, […]

Are Health Plans Insuring Profits More Than Health?

May 27, 2025 — “It’s absolutely insane to try to keep up with it all,” says obesity medicine physician Laura Davisson. She is talking about the impossible maze of requirements that so-called health insurance plans set up to prevent people from securing coverage for medicines to treat obesity. It leads us to ask: Are health plans insuring profits more […]

Dealing with the Money Flowing for Obesity Medicines

April 23, 2025 — ICER, the Institute for Clinical and Economic Review, yesterday brought a sharp focus to the challenge of dealing with the money flowing for obesity medicines. Sarah Emond, ICER’s CEO, explained the challenge and the opportunity of this unique moment: “This new class of obesity medicines offers weight reduction and associated benefits that, if they’re sustained […]