There is overwhelming bipartisan support among Americans for Medicare and Medicaid coverage of anti-obesity medications (AOMs)—the glucagon-like peptide-1 receptor agonist drug class known as GLP-1s. A recent survey commissioned by the Diabetes Patient Advocacy Coalition found that nearly 70%of Republicans, including 68% of Trump voters, support covering GLP-1s in Medicare and Medicaid—a stark contrast to the stated approach of the newSecretary of Health and Human Services, Robert F. Kennedy Jr.
Public opinion is far ahead of current policy on access to anti-obesity medications. These medications are currently prohibited due to a 20-year-old rule preventing Medicare Part D (the prescription drug benefit for Medicare beneficiaries) from covering weight loss medications. It’s important to note that when the Medicare Part D law was passed in 2003, there were no effective weight loss treatments approved by the FDA, and there were several headline-grabbing tragedies caused by dangerous, unapproved treatments being promoted to the general public by bad actors.
Public opinion also defies the persistent blame and stigma often associated with obesity. The notion that obesity is simply the patient’s fault flies in the face of both science and lived experience. A recent study in The Lancet1 reports that 75% of Americans are now classified as either overweight or obese. That only leaves 25% of people left to throw stones in the glass house we are all living in.
The recent poll also underscores the fact that mostAmericans want to be healthy and value access to treatments that will improve their health and quality of life. As a person who has lived with type 1diabetes for over 40 years, I can attest to the frustration of fighting your own body. Obesity creates similar frustrations. Many people diet unsuccessfully as their own metabolisms fight to keep the excess weight in place. Sadly, even the most successful dieters in the short-term are unsuccessful in the long-term as their bodies return to their previous highest weight set point.
When discussing providing coverage for GLP-1s, the dialogue often turns to cost. While these drugs are not inexpensive, plans pay about 40-50% less than the list price quoted by the media after rebates. The real question we should be asking is what is the cost of NOT treating obesity? Obesity is connected to 200 comorbidities including type 2diabetes, heart disease, kidney disease, and 40% of all cancers. Beyond health, obesity impacts our military readiness and contributes to disabilities that remove people from the workforce.
Studies are being released at a rapid pace showing new potential benefits of GLP-1s.
Thus far, we know that GLP-1s have been shown to: 2,3,4,5
GLP-1s are currently also being studied as treatments for:
The return on investment of treating obesity is just beginning to be understood. The USC Schaeffer Center for Health Policy &Economics published a paper estimating that Medicare coverage for GLP-1s could save $175 billion in health care costs in the first decade.6 Goldman Sachs forecasts that broad use of GLP-1s could boost the US gross domestic product by 1% through increased workplace efficiency—an interesting observation as the value of health extends far beyond simply the cost of health care. Imagine the savings to welfare andMedicaid as lower-income Americans, who can’t work due to obesity and related conditions, return to the workforce.
As a society, we have been the proverbial frog in the obesity pot, sitting idly as the water temperature has risen over the past 30 years. Our lives are in growing jeopardy, and it’s time to jump out of the pot and turn down the stove. Americans agree on this topic. Now, policymakers need to act.
George Huntley, CEO
Diabetes Patient Advocacy Coalition
See full poll results here