Insurers Attempt to Prevent Obesity
Although five drugs are currently approved by the
FDA for the long-term treatment of obesity, as of
2015, most insurers don't completely cover these
drugs. It has been estimated that "about
a third of [the insurance] companies don't
cover obesity drugs at all, a third cover all
FDA-approved weight-loss drugs, and a third cover
approved drugs, but with restrictions to limit their
use." And Medicare does not cover the drugs at all.
However, some insurers have taken steps to try to
prevent the onset of obesity.
The obesity drugs, currently available, that have gained FDA approval for long-term use are Orlistat, approved in 1999, Qsymia, approved in 2012, Lorcaserin, approved in 2012, Contrave, approved in 2014, and Saxenda, approved in 2014. In general, each of these drugs can lead to a 5% weight loss. A 5% weight loss can lead to improvements in blood pressure, cholesterol and HbA1c. Still, most insurers don't cover the weight loss drugs because the insurers don't feel that the drugs have been shown to be safe and effective.
The insurers' reluctance to cover the drugs is understandable, given the health problems obesity drugs caused in the past. But while most insurers don't cover these drugs, some of the largest insurers have established programs that may help prevent obesity later in a person's life. For example, Aetna has created programs to fight obesity during childhood, while Blue Cross and Blue Shield and United healthcare have created programs to combat both childhood obesity and childhood diabetes. Further, the Blue Cross Blue Shield program includes an online obesity-preventative resource to help providers manage pediatric patients during office visits.
So while most insurers are reluctant to cover obesity drugs, some insurance companies are taking action, now, that might curb obesity in the future. This is a positive move. Prevention is a key element in the long-term fight to stop the obesity epidemic.
The obesity drugs, currently available, that have gained FDA approval for long-term use are Orlistat, approved in 1999, Qsymia, approved in 2012, Lorcaserin, approved in 2012, Contrave, approved in 2014, and Saxenda, approved in 2014. In general, each of these drugs can lead to a 5% weight loss. A 5% weight loss can lead to improvements in blood pressure, cholesterol and HbA1c. Still, most insurers don't cover the weight loss drugs because the insurers don't feel that the drugs have been shown to be safe and effective.
The insurers' reluctance to cover the drugs is understandable, given the health problems obesity drugs caused in the past. But while most insurers don't cover these drugs, some of the largest insurers have established programs that may help prevent obesity later in a person's life. For example, Aetna has created programs to fight obesity during childhood, while Blue Cross and Blue Shield and United healthcare have created programs to combat both childhood obesity and childhood diabetes. Further, the Blue Cross Blue Shield program includes an online obesity-preventative resource to help providers manage pediatric patients during office visits.
So while most insurers are reluctant to cover obesity drugs, some insurance companies are taking action, now, that might curb obesity in the future. This is a positive move. Prevention is a key element in the long-term fight to stop the obesity epidemic.
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