Medicare doesn't cover obesity drugs, but 76% of older adults

Medicare does not cowl weight problems medication, however 76% of older adults assume it ought to: Ballot

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The overwhelming majority of older adults—83%—assume well being insurers ought to cowl medicines that may assist folks with weight problems handle their weight, a new poll of people age 50 to 80 finds.

Almost as many—76%—consider Medicare ought to cowl these medication, which it can’t at present do underneath regulation, in keeping with the brand new outcomes from the University of Michigan National Poll on Healthy Aging.

A regulation handed in 2003 prohibits Medicare from protecting weight reduction medicines, although it could cowl medication to assist folks with Sort 2 diabetes handle their weight. Medicaid covers weight problems medicines for adults with low incomes in 15 states. Most personal plans and the Veterans Well being Administration cowl them, however with restrictions resulting from excessive month-to-month prices for the brand new era of medicines.

The ballot gauged the curiosity of older adults in taking prescription medicines for weight administration. Among the many 27% of individuals age 50 to 80 who say they’re chubby, 63% are enthusiastic about taking such medicines. So are 45% of these with diabetes, no matter weight. Amongst adults who had ever taken a weight-loss medicine earlier than, 83% mentioned they’d achieve this once more.

“Our information present the sturdy consciousness and curiosity in these medicines, and in entry to them by insurance coverage, alongside protection for different weight-focused care together with diet counseling, train packages and bariatric surgical procedure,” mentioned Lauren Oshman, M.D., M.P.H., an weight problems medication specialist and affiliate professor within the U-M Division of Household Drugs who labored on the ballot.

“We hope these findings will assist inform policymakers and profit plan designers who’re grappling with the tradeoffs of value and long-term profit on the subject of these medicines,” she added. In 2022, Oshman helped lead an evaluation that knowledgeable the Michigan Medicaid program’s determination to cowl weight problems medicines.

The ballot is predicated on the U-M Institute for Healthcare Coverage and Innovation and supported by AARP and Michigan Drugs, the College of Michigan’s tutorial medical heart.

The ballot staff requested a nationwide pattern of adults aged 50 to 80 about their consciousness of, and attitudes towards, weight-management medicines and different weight-related care.

Excessive consciousness

The brand new findings come at a time when injectable GLP-1 medicines resembling Ozempic, Wegovy, Mounjaro and Zepbound have gotten numerous consideration within the information and on social media—overshadowing a earlier era of oral medicines additionally accredited for weight problems and for weight administration in kind 2 diabetes.

The ballot finds that 61% of individuals age 50 to 80 had heard of Ozempic. That drug, which has U.S. Meals & Drug Administration approval just for use in folks with diabetes however has been used off-label for weight reduction, comprises the identical energetic ingredient as Wegovy, which is accredited to be used in weight problems, and which 18% of older adults had heard of.

Subsequent most acquainted was the older drug phentermine, which 13% had heard of. Along with being prescribed alone, it’s also obtainable as a part of the mix medicine bought as Qsymia, which 3% of older adults had heard of. Equally, 3% had heard of Saxenda or Contrave. Zepbound, the obesity-specific type of the GLP-1 drug Mounjaro accredited for diabetes, obtained FDA approval for weight administration after the ballot was taken.

The ballot reveals most older adults had heard concerning the medicines from the information, however far fewer had heard about them from a well being care supplier.

Potential impacts

“As these medicines develop in consciousness and use, and insurers make choices about protection, it is essential for sufferers who’ve weight problems or diabetes, or who’re chubby with different well being issues, to speak with their well being care suppliers about their choices,” mentioned ballot director Jeffrey Kullgren, M.D., M.P.H., M.S., a major care doctor on the VA Ann Arbor Healthcare System and affiliate professor of inner medication at U-M.

“This is a vital dialog within the face of a rising realization over the previous decade that weight problems is a persistent situation with a number of contributing elements that increase downstream dangers of well being issues and {that a} mixture of life-style change and medical or surgical intervention is usually wanted to handle it,” he added.

The newer medicines can value greater than $12,000 a yr for individuals who pay out of their very own pockets and have to be taken long-term to keep up weight reduction. Nevertheless, present information recommend that medicines are practically as efficient as bariatric surgical procedure in serving to folks with weight problems lose 10% or extra of their physique weight, way over folks with weight problems can usually obtain or maintain by food plan and train.

Current findings recommend a big discount within the danger of heart-related points in folks with a historical past of each weight problems and coronary heart situations who took a GLP-1 medicine. The sturdy demand for these medicines, together with for off-label functions by folks prepared to pay full value, has created main shortages of them.

Oshman notes that within the new ballot, practically all older adults mentioned they’d tried to shed extra pounds previously, together with massive percentages who mentioned they’d exercised or modified their food plan.

Extra data:

Offered by
College of Michigan

Medicare does not cowl weight problems medication, however 76% of older adults assume it ought to: Ballot (2023, December 13)
retrieved 20 December 2023

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