For many of the 70 million Americans with obesity, new drugs could spur life-changing weight loss. But a new report from the Institute for Clinical and Economic Review could dampen patients’ chances of accessing those medications.
Problematic Reports
Despite citing the significant benefits of these drugs to patients, ICER’s economists determined that some are not cost effective. It’s a short-sighted perspective and one that could further complicate access to the drugs. But, it’s not a new tune for ICER.
The economists, more often than not, find that drugs they study are not cost effective. But whether ICER is denying public input in its processes, or declaring a drug’s value even before it’s approved by the FDA, the group flexes its power in ways that hurt patients.
By declaring that certain drugs are not cost effective, ICER gives insurance companies the ammunition they need to deny coverage of those drugs. As it pertains to the recently reviewed obesity management medications, Medicare doesn’t currently cover them; neither do the majority of state Medicaid programs or private insurers. Now, ICER’s report will likely make getting the drugs covered even harder, despite the huge burden of obesity.
Obesity’s Significant Cost
As ICER notes in its report, the cost of obesity is monumental, with direct medical costs related to obesity totaling $260 billion in 2016. The problem has an outsized impact on those least able to find solutions – people whose neighborhoods aren’t conducive to safe physical activity or who live in food deserts where healthy food options are scarce.
Beyond the obvious stigma associated with having obesity, the disease increases the chances of developing other serious conditions such as cancer, heart disease and diabetes. Newer FDA-approved therapies could help people lose weight and become healthier, while decreasing costs associated with treating related chronic diseases. Sadly, ICER isn’t helping that cause.
Instead of celebrating helpful tools, the group’s report gives payers cover to deny access to potentially life-changing medications. And, unfortunately, obesity management drugs are just the latest mark in ICER’s cycle – one that is known for pushing innovative medications out of patients’ reach.
