US health policy and prescription drug coverage of FDA-approved medications for the treatment of obesity
Open accessAbstract
Objective Obesity is now the most prevalent chronic disease in the United States, which amounts to an estimated $147 billion in health care spending annually. The Affordable Care Act (ACA) enacted in 2010 included provisions for private and public health insurance plans that expanded coverage for lifestyle/behavior modification and bariatric surgery for the treatment of obesity. Pharmacotherapy, however, has not been included despite their evidence-based efficacy. We set out to investigate the coverage of Food and Drug Administration-approved medications for obesity within Medicare, Medicaid and ACA-established marketplace health insurance plans.Methods We examined coverage for phentermine, diethylpropion, phendimetrazine, Benzphentamine, Lorcaserin, Phentermine/Topiramate (Qysmia), Liraglutide (Saxenda) and Buproprion/Naltrexone (Contrave) among Medicare, Medicaid and marketplace insurance plans in 34 states.Results Among 136 marketplace health insurance plans, 11% had some coverage for the specified drugs in only nine states. Medicare policy strictly excludes drug therapy for obesity. Only seven state Medicaid programs have drug coverage.Conclusions Obesity requires an integrated approach to combat its public health threat. Broader coverage of pharmacotherapy can make a significant contribution to fighting this complex and chronic disease.
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- Authors
- Gomez, G., & Stanford, F. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Corresponding author
- Stanford, F C
- Venue
- International Journal of Obesity
- Published
- 2017-11-20
- Volume
- 42
- Issue
- 3
- Pages
- 495-500
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- PMC
- PMC6082126
- OpenAlex
- W2769181855
- Cited by
- 128
- References
- 18
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 36 · 2023: 22 · 2022: 19 · 2021: 12 · 2020: 7 · 2019: 2 · 2018: 7
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK103946, P30DK040561)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- obesity pharmacotherapy, prescription drug coverage, health insurance coverage, Affordable Care Act, Medicare, Medicaid, phentermine, lorcaserin, phentermine/topiramate, liraglutide, naltrexone/bupropion
- MeSH terms
- Medicare, Humans, Medicaid, Obesity, United States, Anti-Obesity Agents, Prescriptions, Patient Protection and Affordable Care Act
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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