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Calling on Insurers to Cover More Than Digital Bling

Just as obesity is a national epidemic, digital devices are a national obsession.

So it’s not surprising that some insurers are willing to pay for smart watches and digital fitness bands that can help people track their steps or get alerted when it’s time to check their insulin. Coverage for mainstream digital devices through wellness programs is a welcome perk, but it’s not a substitute for insurance coverage of FDA-approved drugs and devices.

Obesity Management Meds Still Excluded

Most obesity management medications, for example, are infrequently covered. It’s a hard truth given America’s losing position in the war against excess weight. Obesity-related illnesses claim 325,000 lives a year and the rate of obesity keeps trending up. If there’s a time to consider pharmaceutical reinforcements, it’s now.

There are several newer, safer drugs, including semaglutide, now available. The “game changingmedication has helped patients lose an average of 15% of their body weight, but it’s not easy for patients to access.

When insurers resist coverage for drugs like it, they are ignoring the much bigger cost of obesity itself, which is estimated to run $147 to $210 billion a year. There’s also the cost and impact of related chronic conditions like cardiovascular disease and type 2 diabetes. Given these stakes, supporting access to innovative treatments sounds like a prudent investment.

PDT Uptake Lags Due to Coverage Limits

Like obesity medications, prescription digital therapeutics are seldom covered by health plans.

The new and rapidly expanding class of FDA-approved software-based applications can be used to support treatment for a variety of mental and physical ailments. Insomnia, irritable bowel syndrome and chronic lower back pain are among the conditions treated by currently approved PDTs. They have also been found to be helpful for conditions that require behavioral adherence, like diabetes and opioid use disorders.

Prescription digital therapeutics engage patients where they are. And the technology also allows doctors to safely receive real-time patient data, enabling changes to medications or treatment plans between office visits. In short, PDTs can improve the efficiency of patient-centered care for people with a wide range of conditions.

Despite the current performance and future promise of medications and technologies, patients’ ability to reap their benefits is slowed by continued reluctance of payers to cover them. Public and private insurers alike would be wise to reconsider ongoing barriers to health care’s newest innovations.

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