Posts Tagged ‘health insurance’

“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 […]

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 […]

As everyone digests the news that CMS has chosen not to expand coverage of obesity medicines under Medicare and Medicaid “at this time,” it is becoming clear the door is not closed. HHS told Bndpoints News: “CMS may consider future policy options for obesity medications pending further review of both the potential benefits of these […]

In the U.S., we are at a critical point for the sourcing obesity medicines. March 19 was the last day that FDA would tolerate large scale compounding of tirzepatide on account of the now resolved shortage of that drug. The same milestone for semaglutide is coming up on May 22. Some people are not happy. […]

There’s no denying it. More people are getting access to care for obesity than ever before. In part this is because health professionals have a range of tools for providing that care. GLP-1 agonists like semaglutide and tirzepatide are a big part of that.But those drugs carry a price tag that is blowing up pharmacy […]

Seemingly limitless demand for obesity meds, botox, and lip fillers is driving robust growth for med spas in the U.S. The medical spa industry reports expansion from 1,600 locations in 2010 to more than 10,000 in 2023. The revenue for an average spa more than doubled to $1.4 million per spa. In 2023, that added […]

A new study in JAMA Network Open makes one thing very clear. Most people who take GLP-1 medicines for obesity quit within a year. Most who take them for diabetes are less likely to quit. Why are the disparities in GLP-1 medicines for obesity so great in comparison to their use for diabetes? It’s all […]

Last week we got another glimpse of incremental progress in coverage for obesity medicines in health insurance plans. CMS announced that Medicare drug plans (Part D or Medicare Advantage) could now cover Zepbound (tirzepatide) when doctors prescribe it to patients for obesity and sleep apnea. This is not the opening of floodgates. It is movement […]

The docket is open for you to lend your support until January 27. The Center for Medicare and Medicaid Services (CMS) is proposing to open up access to obesity medicines in both of the programs they oversee. This is something that we – with virtually every advocate for obesity care – have been seeking for […]

Some pharmacy benefit plans have taken a dark turn when it comes to obesity medicines. Let’s not sugarcoat it. They are exploiting people with obesity through abusive copays on drugs like Wegovy and Ozempic – two brands of semaglutide. These PBMs pretend they are covering part of the cost of the drug. But in fact, […]