Dear
Are you aware that our company’s health plan contains an exclusion for anti-obesity medications? I’m not just referring to the newer anti-obesity medications (expensive GLP-1 receptor agonists such as Wegovy and Saxenda), but also older anti-obesity medications such as Qsymia, Contrave, and Phentermine – all of which are significantly less expensive than the new injectable medications. Many times, when crafting a pharmacy benefit plan, these medications are overlooked or ignored.
Obesity is a complex, multifactorial, common, serious, relapsing, and costly chronic disease that serves as a major risk factor for developing conditions such as heart disease, stroke, type 2 diabetes, renal disease, non-alcoholic steatohepatitis, and certain types of cancer.
Every major medical organization in the United States supports and recommends comprehensive evaluation and treatment of patients suffering from obesity. The American College of Cardiology (ACC), The American Heart Association (AHA), The Obesity Society (TOS), The American Association of Clinical Endocrinologists (AACE), The American College of Endocrinology (ACE), The American Gastroenterological Association (AGA), and many others recommend that patients with obesity be offered an intensive lifestyle intervention as initial treatment for excess weight. If that isn’t sufficient to cause clinically meaningful disease regression, the addition of anti-obesity pharmacotherapy and/or bariatric surgical procedures is recommended.
Due to the widespread media coverage of these new, expensive anti-obesity medications and their high efficacy, demand for them is tremendous. If our employee population closely mirrors that of the general US population (with over 42% suffering from obesity), expanding coverage to include these medications for everyone who qualifies for them isn’t feasible at this time. However, given the relatively low cost of the older anti-obesity medications and the fact that they typically result in clinically significant weight loss, I’m requesting that they be covered for plan participants who require pharmacologic help with obesity treatment.
Coverage of these medications allows patients with obesity to have access to improved outcomes and, when deployed responsibly, along with comprehensive lifestyle interventions, has been shown to lower overall healthcare costs.
There is a plethora of data that a 5% decrease in weight results in clinically significant improvements in most obesity-related comorbid conditions. Providing coverage for treatment for the disease of obesity can prevent catastrophic events and significant increases in the overall cost of healthcare. Employees should be encouraged to aggressively treat this disease.
I am writing this to encourage you to reconsider this exclusion and consider covering older anti-obesity medications for members when they are prescribed by clinicians with advanced training and experience practicing Obesity Medicine. Our area has several medical clinics staffed by physicians board-certified in Obesity Medicine and mid-level providers with advanced training in Obesity Medicine. These clinics treat the disease of obesity using evidence-based medicine and operate similarly to other medical clinics. They have experience using STEP therapy with anti-obesity medications. I have recently been seen by one or more providers at Heartland Weight Loss, which is how I learned about our lack of coverage and available therapies.
If you want to learn more about Heartland Weight Loss before making a final decision, you can learn more at www.HeartlandWeightLoss.com or you can reach out to them directly at Succeed@HeartlandWeightLoss.com The office was founded by Courtney Younglove, M.D., who is board-certified in Obesity Medicine and is one of only seventy physicians in the US and Canada who has earned her fellowship from the Obesity Medicine Association. Dr. Younglove and her team feel strongly that patients struggling with obesity should have access to high-quality medical treatment and FDA-approved treatments for excess weight. They provide a high-quality alternative to med spas and online companies providing bootlegged, non-FDA-approved medications to treat obesity without a comprehensive lifestyle intervention.
Thank you for supporting me as I work on improving my health and my weight. Improving my health will not only benefit me individually but should also help the company as a whole. In addition to decreasing overall healthcare costs, reducing obesity typically results in happier, more productive employees.
Regards,