The American Medical Association wants insurance companies and federal payers to fully cover a new class of obesity treatments like Wegovy and Ozempic, even as plans search for ways to avoid paying for the high cost of the drugs.
The organization voted Monday to pass a resolution supporting “health insurance coverage parity for evidence-based treatment of obesity, including FDA-approved medications without exclusions or additional carve-outs.”
The AMA said it regards obesity as a disease that poses a major health concern and can put patients at risk for serious health consequences if left untreated.
The vote from the nation’s top physician lobby ratchets up pressure on insurers and the federal government.
Federal law bars Medicare from covering weight-loss drugs, though Congress is considering taking steps to change the policy. Private insurers have been unwilling to cover weight-loss drugs because they are viewed as lifestyle or cosmetic medicine and not essential.
Diabetes treatments like Ozempic and Mounjaro have been used off-label for weight loss, but a new class of medicines called GLP-1 treatments like Wegovy and Zepbound are now officially approved by the Food and Drug Administration for obesity.
They can help patients lose a dramatic amount of weight, but cost more than $1,000 a month. In addition, almost half the country may be eligible because so many people are considered overweight or obese. As a result, insurers have been instituting policies like lifetime coverage caps, onerous paperwork rules, or even outright refusal to cover the FDA-approved drugs.
“The costs for the patient and broader health care system associated with obesity, including the treatment of weight-related conditions and potential complications, can be substantial,” AMA said. “It is crucial to recognize the urgency of addressing this disease comprehensively and proactively through a range of suitable treatments.”