Dying younger. Living harder. Going broke. It is difficult to overstate the longitudinal effects of excess weight in America.
An estimated seven in 10 Americans are overweight or obese. The combination, according to the National Institutes of Health, results in an estimated 300,000 preventable deaths per year with extreme obesity lowering life expectancy by 14 years on average.
Added weight not only makes everyday life more difficult, but it also produces serious health consequences that include cardiovascular disease, diabetes, musculoskeletal disorders and cancer. In total, obesity costs an estimated $260 billion annually in inpatient and outpatient care.
Whether weight gain is caused primarily by genetics, societal influences or individual will, scientists aren’t altogether sure. What’s clear, however, is that most efforts to lose weight ultimately fail.
Ozempic, one of a new class of medications, has been shown in studies to spur significant weight loss. The others include Mounjaro, Rybelsus and Wegovy with several new (and convenient, pill-based) options in development.
Last year, more than 5 million Americans were prescribed one of these drugs for weight reduction.
The annual price of treatment ranges from $12,000 (Mounjaro) to upwards of $16,000 per year (Wegovy). As a result, most users are either wealthy or have generous health-insurance coverage.
But as more Americans seek these medications for moderate weight loss, not diabetes, insurers have started clamping down. They’ve issued threatening letters to doctors, warning they’ll be referred to state regulatory boards for writing “off-label” prescriptions.
Ozempic and other medications that help with weight loss are part of an ongoing national debate in which two competing truths collide.
The first truth is that these drugs work, leading to significant and sustained weight reduction: 14 to 25 pounds per individual on average during the medication course. And while they’re not a replacement for proper nutrition, exercise or healthier living, they do reduce the likelihood of heart attack, stroke and cancer.
Second, despite the medical opportunity at hand, making these drugs available to all 100 million obese American adults would prove cost prohibitive for businesses, private insurers and the government.
This means that the medications could drastically rollback the nation’s $260 billion in obesity-related medical expenses each year, but prescribing them at today’s prices would cost more than $1.5 trillion annually — increasing national health care expenditures by as much as 25%.
What’s more, these medications are considered “forever drugs,” requiring users to either maintain their dosage or regain most of the weight they lost.
Insurers are eager to draw a line between those seeking prescriptions for appearance’s sake and those at heightened risk of disease or death. They’re happy to cover the latter but, as with cosmetic surgery, insurers believe patients should foot the bill for the former.
Lost in this debate is an important question: Why not figure out how to make these lifesaving drugs broadly available and affordable?
