As a weight management doctor, Mollie Cecil saw first -hand that the latest weight loss remedies help their patients.
He also knows from personal experience: after a year on one medicine, the Western Virginia doctor lost 40 pounds. Her cholesterol and arthritis improved, allowing her to be more active with her young children.
“I just felt like a new person on them,” she said.
But she took care of the same obstacle facing many of her patients – loss of insurance – so she narrowed medication as a precautionary measure.
It turned out to be right. Dr. Cecil later found out her new non -profit insurance plan He couldn’t afford to cover the drug costs.
She gradually gained much of the weight she lost.
New weight loss medication?
The latest class of weight loss drugs and as GLP-1 agonists-SU “The strongest weight loss medicines we’ve ever had,” said Dr. Cecil.
“But when I can’t make them [my patients]As a doctor who really cares for people’s care … it simply feels helpless, “she said.
New drug class – is often not covered by private insurance – on average it can cost $ 1,000 (809) a month. Federal law forbids Medicare to cover medication when used for Weight loss, although they are usually covered when used to treat diabetes and cardiovascular diseases. Only 13 countries ensure coverage of Medicaid for the purpose of weight loss.
To make them more affordable, then President Joe Biden recently suggested that Medicare and Medicaid cover them, but now it will be on the new administration of President Donald Trump.
His weight loss drug policy would fall on Trump’s selection of health minister, Robert F Kennedy JR and Mehmet Oz, Trump’s choice for the leading of Medicare and Medicaid services. But that could mean a potential conflict: Kennedy is a vocal critic of weight loss medication, while Oz is a burning advocate.
Trump’s administration did not respond to the request for comment on how to cope with the proposal of Biden Administration for Medicare – federal insurance for those 65 and more than 65 years – and Medicaid – Government Insurance for people with low income – to cover medication.
Trump’s future approach remains unclear, with several people in his inner circle they hold contradictory views, said Jonathan Zhang, a professor at the Sanford School for Duke University Public Policy.
“GLP-1, Oskempic, this is a drug that has so much demand for patients,” said Mr. Zhang. “It’s really a life on social media. Therefore, Trump’s administration – or any administration – is facing a tone of pressure to do something about it in the short term.”
Skeptic drug with weight loss over television promoter
During his presidential ride last year, Kennedy made the epidemic of obesity to the central part of their platform. According to the US Centers for Disease Control and Prevention in the United States, over 100 million people in the USA in Objeilo.
After giving up and approved Trump, Kennedy launched his “Make American Health Health” initiative to reduce obesity by removing ultra -processed food and additives, among other more controversial ideas.
But the 71-year-old was expressed in October about weight loss drugs, saying Fox News: “They count on sale [weight-loss medications] Americans because we are so stupid and so much addicted to drugs. “
“If we only gave good food, three meals a day, every man, woman and a child in our country, we could solve an epidemic of obesity and diabetes overnight,” Kennedy added.
Shortly after Trump chose Kennedy to run the Health and Human Services Department (HHS), he announced that he chose Oz, former host and surgeon TV show, which will run the Medicare and Medicaid (CMS) centers within HHS which manages state health insurance.
As a television show, OZ spent years promoting various weight loss medicines, including GLP-1 medicines in recent times.
“For those who want to lose a few pounds, the ground and other semaglutide medicines can be a great help,” Oz announced on Instagram 2023. “We need to make it easier to fulfill our health goals, the period.”
The decisions on the coverage of Medicare and Medicaid drugs would probably include leaders and HHS CMS, experts said.
Oza spokesmen and Kennedy did not respond to the requests for comment on how they would deal with a decision on politics. Neither was confirmed.
‘Huge’ price
The high price of GLP -1 drugs, which are patented – which means cheaper versions of Copycat cannot be guided – has led to a discussion among the insurance companies, said Benjamin Rome, a healthcare shelves researcher at the Harvard Medical School.
Companies have to decide whether to increase insurance premiums, in general, to cover the costs or completely give up covering GLP-1, he said.
Many have decided not to cover them. Others interrupted the coverage of patients after they lose weight and achieve body mass index (BMI) below the obesity range of 30 or more, said Dr. Cecil.
When Dr. Cecil was on GLP-1 using her previous insurance, she said she would not allow her to lose as much weight as she wanted to avoid going by BMI Prague.
“It will cut the coverage, saying,” Well, you no longer need it. You lost weight. “But of course, the reason why they lost weight is because of the cure,” she said.
Too fast removal of obesity medicines can also cause the unpleasant effects of withdrawal and many gain weight.
Government insurance faces similar costs when it comes to covering new weight loss remedies.
“Although it is obviously a lot of interest in how these very effective drugs would be more accessible to the patients they need, the cost of it would be huge because so many people are acceptable and because the prices are so high,” Dr. Rome said.
When Biden’s officers issued a rule that demands that Medicare and Medicaid cover obesity medicines, they did so after the election, knowing that they would not be on them to make politics, said Mark Fendrick, director of the University of Michigan Insurance Center based on values.
Last year, the Federal Government announced that Medicare could cost about $ 25 billion for Medicare and $ 11 billion for Medicaid to provide medicines in the next 10 years.
“How to pay for it?” asked Dr. Fendrick.
The rule from the Biden Era must go through a public comment period before Trump’s administration ultimately decides whether to go forward with it, experts said.
Dr. Cecil said that the government and private insurance companies can remain hesitant to carry an account for such expensive medicines.
But he believes that the savings that would come from solving obesity for millions of Americans would greatly exceed short -term costs.
“Five to ten years, if we really saw a huge payment, because then we would really start to see the trend downward for some of these serious long -term complications,” said Dr. Cecil.
“If everyone who needed drugs could afford and wanted to take them, that would change a lot.”
