GLP-1 medications like Ozempic and Wegovy remain in high demand and continue to make headlines, even among mainstream media outlets. As the healthcare industry watches closely to see how payers decide to cover the drugs going forward, it’s important to remember that GLP-1s won’t be able to solve the country’s obesity crisis by themselves, payer executives said during a virtual panel held Thursday by Bright Spots in Healthcare.
Obesity is not only a chronic condition, but also usually a complex condition, noted Shelley Turk, divisional senior vice president of healthcare delivery at Blue Cross and Blue Shield of Illinois.
Ideally, a patient with obesity would get diagnosed by their primary care physician, who would serve as a quarterback for their care and connect them to the team of specialists needed to address the condition and its root causes — such as nutritionists, mental health professionals and endocrinologists. But it rarely works out this way, and obesity management is usually a quite fragmented experience for patients, Turk said.
“You can have managed written referrals by the primary care physician, but there’s a lack of incentive for that primary care physician to really have a discussion with patients or ensure proper documentation that this person actually has obesity. Part of that is because traditionally, providers haven’t been compensated for obesity,” she explained.
Turk also pointed out that less than 10% of primary care physicians are trained in obesity medicine.
In her view, payers, providers, tech companies and other healthcare stakeholders need to fuse their data to form a cohesive view of members’ obesity stories on an individual basis.
That way, payers can better manage cases and determine what treatment options would be most effective for the member at hand — whether that is a GLP-1, other weight loss medication, surgery, remote monitoring program, nutrition coaching, treatment for high blood pressure, or any combination of these interventions.
Personalized treatment was also highlighted by Mamata Majmundar, chief medical officer at Texas-based payer Evry Health.
“Our goal is to create habits and give people the tools and resources they need to gain success. That way, they can continue to sustain those changes,” she declared.
While it is true obesity treatment is often most effective when personalized, that doesn’t mean that there aren’t community and population health issues at the center of the nation’s obesity crisis, Majmundar added. Payers should consider these issues too — that means advocating for walkable cities and better access to healthy food, she said.
Photo: aykut karahan, Getty Images
