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When insurance companies will cover weight-loss drugs

November 12, 2024
in Trade Tube
Reading Time: 3 mins read
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George Hampton, CEO of Currax Pharmaceuticals, joins TheStreet to explain what needs to happen in order for weight loss drugs to become covered by insurance companies.

Transcript:

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ONWAY GITTENS: What is it going to take to change that scenario in terms of major health coverage for these anti-obesity drugs?

GEORGE HAMPTON: Well, we’re trying every day. I spend a lot of time in DC. We’re working on a bill that we call troa the treat and reduce obesity act. And I think it has incredible promise and it could even be passed this year. We have a lot of support from all the senators and all the Congress people. It just comes down to being able to pay for it along the way in the budget.

CONWAY GITTENS: So from your viewpoint, what exactly is the issue. Do they feel like the drugs are too new and unproven for them to put their backing or their money to cover it. Or like, what’s the issue?

GEORGE HAMPTON: It’s the budget. It’s how much money do we have to cover obesity and what will it cost. And so the Congressional Budget Office has recently released its estimate of what it will cost the country to pay for that. It was a very low number compared to what people were estimating. And so we’re very encouraged that this could happen. This year before the end of the year.

CONWAY GITTENS: So do you need the government health insurance plans to start paying in order for the private health insurers to get on board or that kind of thing?

GEORGE HAMPTON: It is to some degree. And so the government, for example, when they start paying for something, the commercial plans often feel compelled to do the same, but it’s not 100% And so you think of it in smoking cessation. Back in 2010, under the ACA, the smoking group was finally able to be paid for by the government, and the commercial payers followed right along. And we think the same thing will happen here with weight loss.

CONWAY GITTENS: And so is it all about lobbying. What does the industry have to do to convince the health care insurance industry and the government, for that matter, to pay to start paying for this. Or is it just that because there are so many obese people and they look at the numbers, they’re like we don’t want we don’t have the money for that. Is that what it is?

GEORGE HAMPTON: Well, to some degree, you have to go all the way back. A little bit of history. You have to go all the way back to 2002 when Medicare Part D first came into play under Bush, Bush the second. At that time, there were certain medications and certain classes of medications that were carved out. Ed products, aesthetic products, smoking, weight loss. They were all carved out as more lifestyle, more lifestyle diseases. And so they weren’t covered. Going forward, we know that we need to cover it because we’ve ignored this obese population. We haven’t always been, as a population, 43% obese across the United States as adults. We’ve ignored the problem. We have not intervened like we have with every other chronic disease. And therefore, the disease is kind of run, run its course. And we see it everywhere.

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