Hi.
What are your thoughts on the Treat and Reduce Obesity Act? Do you believe that obesity treatments should be covered in US and could a similar initiative be developed in Europe? The weight-loss medication Wegovy has been recently covered in US for patients at risk of heart attacks and strokes. However, GBA has classified Wegovy as a “lifestyle drug,” excluding it from statutory health insurance reimbursement
Best,
Isabelle
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Hi!
In my opinion, things have to change. It is hard to speculate about similar initiatives in the EU because the perception of obesity varies between the US and EU and even among EU countries. In the UK and France, there are anti-obesity drugs that are reimbursed, but as you mentioned, in Germany they are excluded from coverage. The rationale for the approach adopted in Germany is the fact that the use or need for these drugs is determined by patients’ life-style, thus, it is appropriate that people themselves are responsible for their funding. I do not agree with that completely. For example, lung cancer treatment is reimbursed even if the patient is a smoker.
In the US, it is also complicated. Currently, the law forbids coverage of anti-obesity drugs by Medicare, however, this law was established 20 years ago, when these drugs were considered more as cosmetic therapy.
Obesity is a huge problem in the US, but this also means that the population of people that could benefit from the reimbursement of anti-obesity drugs will be large, and that will be a challenge for the payers.
Also, my personal thought is that the drug itself should not be perceived as a miracle but as an adjunct to a reduced-calorie diet and increased physical activity.
I am very curious about other opinions 
Wegovy has been approved not solely for the coverage of overweight and obesity management but to reduce the risk of major adverse cardiovascular events in overweight and obese people. That decision is a consequence of the updated FDA indication. Before that, when indicated only for weight management, Wegovy was excluded from the coverage.
I have just discovered data suggesting that the population eligible for Wegovy coverage under current conditions may represent just over a quarter of Medicare beneficiaries diagnosed with overweight or obesity! A New Use for Wegovy Opens the Door to Medicare Coverage for Millions of People with Obesity | KFF
And one more interesting fact: tirzepatide, another GLP-1 agonist, is seeking to expand the use of its weight-loss drug into sleep apnea in overweight and obese people. If granted, I think there’s a chance that treatment for that particular population will be covered by Medicare 