Senators, obesity group call on CMS to cover weight-loss therapies
Two senators called on CMS to lift regulations that deny insurance coverage for obesity drugs and that limit coverage of intensive behavioral therapy during the COVID-19 pandemic.
In a July 1 letter addressed to CMS administrator Seema Verma, MPH, Sen. Thomas Carper, D-Del., and Sen. Bill Cassidy, R-La., urged the agency to “recognize the tremendous impact that COVID-19 is having on the health outcomes of so many Americans affected by obesity” by updating a nearly 20-year-old statute in the Medicare Part D prescription drug program that specifically excludes obesity pharmacotherapy from Medicare coverage.
The senators are primary co-sponsors of the Treat and Reduce Obesity Act, first introduced in 2013, which would allow CMS to expand Medicare Part D coverage to include FDA-approved prescription drugs for obesity and expand intensive behavioral therapy.
“As our country continues to deal with the response and impact of COVID-19, we have learned that obesity is the second greatest risk factor, after older age, for hospitalization among COVID-19 patients,” the senators wrote. “A report from the CDC reveals that 78% of COVID-19 patients requiring admission to an ICU had at least one underlying health condition, many of which were obesity-related diseases. Data from New York City indicate that people with both COVID-19 and obesity are two times more likely to be admitted to the hospital, and people with severe obesity are 3.6 times more likely to require critical care, such as mechanical ventilation.”
In an interview, Matthew Hutter, MD, MBA, MPH, professor of surgery at Harvard Medical School and president of the American Society for Metabolic and Bariatric Surgery (ASMBS), said people with obesity often face significant stigmatization and bias, further hindering uptake of available therapies.
“Obesity is a disease,” Hutter told Healio. “COVID-19 is making people aware of that. This bill, which is well supported on both sides of the aisle, just needs the impetus to get passed.”
Hutter said a change in Part D coverage for obesity treatments would hopefully spur other insurers and payors to follow the lead of CMS.
“In the past, there have not been very effective treatments for obesity, and now there are more FDA-approved medications that can be used long term and show effectiveness,” Hutter said. “People are not as well educated about that.”
More than 185 members of Congress are currently on record supporting the Treat and Reduce Obesity Act, but the bill has yet to come up for a floor vote since it was first introduced in 2013, according to ASMBS.
ASMBS has advocated for increased access to obesity treatments during the pandemic. As Healio previously reported, ASMBS published a statement in June that bariatric surgery can improve obesity and the related diseases that increase risks for worse COVID-19 outcomes and should not be considered an elective procedure.
For more information:
Matthew Hutter, MD, can be reached at email@example.com; Twitter: @ASMBS.