Dr. Laure DeMattia, a bariatric medicine specialist in Norman, Oklahoma, observes her patients’ struggles with weight loss, many of whom could benefit from new medications like Ozempic and Wegovy. Despite their potential, these drugs are financially inaccessible for most patients, particularly those under Medicare and Medicaid.
In the United States, around half of the adult population faces obesity, increasing the risk of heart disease, diabetes, and certain cancers. However, disparities are evident in the accessibility of semaglutide, a key component in these medications, with a significant majority of prescriptions going to white individuals, despite higher obesity and diabetes rates in Black adults.
These medications, praised for their revolutionary approach to obesity treatment and popularized by celebrities, are scarcely used due to their high cost. The majority of insurance companies refuse to cover the steep monthly expense, placing a burden on those who need them the most.
Dr. Peminda Cabandugama from the Cleveland Clinic points out that obesity management often benefits only those with superior insurance coverage. Oklahoma, for example, has a high obesity rate but low prescription rates for semaglutide. In contrast, West Virginia, which has the highest adult obesity rate, had higher prescription rates, possibly because state employees’ medication costs were covered until recently.
Dr. Ryan Morgan, an Oklahoma-based physician, mentions that insurers often don’t cover these medications, viewing obesity as a cosmetic issue rather than a chronic disease. A significant barrier is a 2003 law preventing Medicare from covering weight loss drugs, influencing private insurance policies.
The Food and Drug Administration’s expansion of Wegovy’s approval for reducing heart attack and stroke risk may encourage more insurers to cover these drugs. However, high costs and limited competition remain hurdles to accessibility.
Specialists like Dr. Drake Bellanger in Louisiana see a high dropout rate among patients due to the denial of medication coverage, leading to disappointment and a feeling of helplessness among those who can’t afford these potentially life-changing treatments.