Are weight management medications coming to your insurance plan?

As a follow up to my previous post I have some interesting thoughts on Ozempic and telemedicine weight loss clinics. Recently a study was published about the success of online weight loss clinic. The study is performed and published by Calibrate. The results are impressive showing a 16.2% weight loss sustained over 24 months.

Stand alone, these are interesting findings and raise interesting questions about the treatment of obesity. Current guidelines include consideration of bariatric surgery (eg. gastric bypass) for anyone with BMI over 30. Outcomes are very good in terms of weight loss, diabetes remission and reduction in cardiovascular disease risk factors. However, the overall risk of major complication is estimated at 4% and jumps significantly when performed by the lower quartile of bariatric surgeons.

Could this be the beginning of a paradigm shift from surgery toward medication as complications of gastric surgeries run higher than with the medication. In addition, one only need to stop the medication to stop adverse effects vs surgical complications. We can even throw dietary changes with intensive touch points and no new medication via a program like Virta Health. This program has excellent outcomes that exceed success of traditional weight loss programs.

Even more interesting is the list of Calibrate investors. There are several tech and healthcare focused VC companies. However, among the list is Optum Ventures. They are part of the United Health Group portfolio of companies as is Optum, United’s health services company. Optum takes risk as value-based care arrangements from United Health and generates huge profits by offering more cost-efficient care. So, is Optum going to start offering telemedicine weight loss with medication? Why not? Optum is spending millions on chronic disease management like diabetes, chronic kidney disease, hypertension and heart disease as well as orthopedic surgeries all more common among the obese population. Optum already uses many other companies in the OptumVentures portfolio.

Insurance companies already offer wellness incentives to members. Why wouldn’t they offer early treatment for obesity which leads to so many health costs and consequences?