Eli Lilly’s tirzepatide was recently approved for weight loss by the US FDA. A newly published study in the New England Journal of Medicine shows that the drug has similar effects to gastric bypass surgery. The data further supports the use of the drug to treat obesity, which is associated with conditions like cardiovascular disease, diabetes, and some cancers. Patients with a BMI 30 or greater that took the drug and got counseling for healthy eating and exercise lost 20.9% of their body weight in 72 weeks, compared to 3% body weight loss in the placebo group. This has big implications for patients, providers, and payers.
According to Dr. Katherine H. Saunders, “Second, the more anti-obesity medications that are available, and the more effective they are, the more health insurance companies will see the value of covering medical obesity treatment and seeking to tackle this chronic disease early, before further complications develop. Older drugs Contrave and Qsymia are approved for chronic obesity treatment and generally produce weight loss in the range of 5-10%. A new medication, Wegovy, approved last year, was the first breakthrough drug to produce 15% weight loss and it has proven so successful that it doubled the number of prescriptions for branded anti-obesity medications in one year. Although the American Medical Association recognized obesity as a chronic disease in 2013, many health plans still exclude obesity medications from coverage, as they view obesity as a mere lifestyle issue or consider weight loss to be a “cosmetic” or “vanity” treatment. As insurance coverage expands, more people will be able to access care, which should lead to improved individual health outcomes and ultimately a reduction in the overall healthcare cost burden.”
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(Source: September 9th, 2022)