Doctors say weight-loss drugs are only a part of the most effective strategies to treat a patient with obesity.
When Dr. Andrew Kraftson develops a plan with his patients at the University of Michigan’s Weight Navigator program, it involves a “perfect marriage” of behavioral intervention, health and diet education, and possibly anti-obesity medication.
But with Medicare patients, he is limited in what he can prescribe.
“A blanket prohibition for use of anti-obesity medication is an antiquated way of thinking and does not recognize obesity as a disease and is perpetuating health disparities,” Kraftson said. “I’m not so ignorant to think that Medicare should just start covering expensive treatments for everyone. But there is something between all or nothing.”
Lawmakers have introduced some variation of legislation that would permit Medicare coverage of weight-loss drugs over the last decade. But this year’s bill has garnered interest from more than 60 lawmakers, including self-proclaimed budget hawk Rep. David Schweikert (R-Ariz.) and progressive Rep. Judy Chu (D-Monterey Park).
Passage is a top priority for two lawmakers, Wenstrup and Sen. Tom Carper (D-Del.), before they retire next year.
Pharmaceutical companies also are readying for a lobbying blitz next year with the drugs getting the OK from the FDA to be used for weight loss.
“Americans should have access to the medicines that their doctors believe they should have,” Stephen Ubl, the president of the lobbying group, Pharmaceutical Research and Manufacturers of America, said on a call with reporters last week. “We would call on Medicare to cover these medicines.”
Already, Novo Nordisk has employed eight separate firms and spent nearly $20 million on lobbying the federal government on issues, including the Treat & Reduce Obesity Act, since 2020, disclosures show. Eli Lilly has spent roughly $2.4 million lobbying since 2021.
Advocates for groups such as the Obesity Society have been pushing for Medicare coverage of the medications for years. But the momentum may be shifting, thanks to the growing evidence that the obesity drugs can prevent strokes, heart attacks, even death, said Ted Kyle, a policy advisor.
“The conversation has shifted from debating whether obesity treatment is worthwhile to figuring out how to make the economics work,” he said. “This is why I now believe the change is inevitable.”