Semaglutide, sold under the brand names Ozempic and Wegovy has skyrocketed in use for its ability to aid weight loss. However, some companies are backing down from coverage due to their high cost. For instance, the private healthcare system Ascension stopped coverage on July 1, stating that weight loss and anti-obesity drugs will no longer be covered in its pharmacy benefit to its nearly, employees. The company noted that this applies to glucagon-like peptide 1 GLP-1 receptor agonists Wegovy and Saxenda and anti-obesity medications such as Ascension noted that new weight loss medications that become available in the future will not be covered either. Ted Kyle, RPh, founder of ConscienHealth, which advocates for evidence-based prevention and treatment of obesity, said healthcare is in an awkward place in obesity care.

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Abstract: Obesity is among the most common causes of morbidity in the United States. Few patients and providers are aware of effective treatment options for obesity besides bariatric surgery and lifestyle interventions. It will address the indications, options, costs, benefits, and effectiveness of United States Food and Drug Administration FDA -approved weight loss medications currently on the market. Obesity is one of the most common causes of disability today. In the United States alone, nearly two-thirds of Americans have overweight or obesity.

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Experts estimate that about one third of insurance companies cover all FDA-approved weight loss medications, another third cover some drugs in some cases, while the remaining third do not cover any pharmaceutical therapy for obesity 3. Weight loss significantly improves health outcomes for the vast majority of patients, but insurance companies may not see those savings for phentermine costs goodrx to come. So, profit-driven insurance companies, especially those with high patient turnover, are often hesitant to cover preventative treatments like weight loss medications. The US Preventative Task Force repeatedly fails to recommend pharmaceuticals as an advisable treatment for obesity in the primary care setting 5. So, safety concerns in the absence of proven efficacy act as another barrier to more-universal insurance coverage. Finally,weight loss medications have a reputation problem too.

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