Even among the insured, weight-loss drugs are rarely prescribed, the study suggests

Powerful weight-loss drugs aren’t reaching the people who need them most, according to researchers at the Johns Hopkins University School of Medicine in Baltimore.

The barriers to medicines are many: Obtaining a prescription; find a pharmacy with the medicine in stock and be able to pay for it.

Obesity has been a long-standing clinical and public health issue and its scope is growing, said Dr. Chiadi Ndumele, director of obesity and cardiometabolic research in the division of cardiology at Johns Hopkins Medicine in Baltimore, who to present the findings to an American institute on Tuesday. Heart Association meeting in Chicago. The findings have not yet been published in a peer-reviewed journal.

In recent years, we’ve developed increasingly powerful pharmacotherapies, particularly these GLP-1 receptor agonists, which have a pretty profound impact on obesity, he said, referring to the class of drugs that includes Ozempic, Wegovy and Zepbound.

That said, Ndumele said, we still recognize that the uptake of these agents is still quite limited.

The new findings come shortly after NBC News reported on the stark racial and geographic disparities seen in the United States among those prescribed a weight-loss drug.

Insurance, in particular, can be a major obstacle, given the drugs’ expensive list price, averaging about $1,000 a month. But the Hopkins researchers found that even among patients whose insurance covered the drugs, a doctor was still unlikely to write a prescription, if not rare.

Coverage is very important, but coverage is only part of the story, Ndumele said.

The study analyzed the health records of 18,000 patients who had attended a Johns Hopkins outpatient clinic from January to September 2023.

All were obese, meaning a body mass index of at least 30, and all had insurance coverage for the drugs.

The researchers found that only 2.3% were prescribed a weight-loss drug.

That figure didn’t surprise Ndumele, who said factors like the cost of co-pays and the hassle of getting prior authorization may be among the reasons people didn’t get prescriptions.

There’s also an additional question about how comfortable we are currently in engaging in the obesity conversation with patients, Ndumele said. I’m a physician who focuses a lot on obesity and I can tell you, in terms of research and clinically, there are often some who are not always the most adept at raising the conversation about obesity. As a result, it is often not treated in clinical settings.

That, along with weight bias and weight stigma, he said, can affect how the topic of weight-loss drugs can come up.

Among the small portion of patients who received a prescription for a weight-loss drug, disparities were evident: In general, white adults were more likely to receive a prescription than Asian or black adults.

Adults with a BMI of 35 or higher, hypertension, or type 2 diabetes were also more likely to receive a prescription. However, the disparity between black and white adults still remains, with white adults more likely to receive a prescription, despite higher rates of severe obesity and hypertension among black adults.

The researchers found that adults in their 40s were more likely to receive a prescription compared to other age groups. Women were more likely to receive a prescription than men.

Ndumele noted that the study’s 18,000 participants visited a wide range of outpatient clinics at Johns Hopkins and were not limited to primary care or weight-related care. Some may have gone to a dermatologist or gynecologist, for example. A patient’s weight and weight loss medications may not have been the subject of the visit.

Dr. Christopher Chapman, a board-certified gastroenterologist in obesity medicine at Rush University Medical Center in Chicago, said additional factors such as office talk and drug shortages may also play a role in the limited number of written recipes

If you solve the insurance problem, you have an advantage, but you don’t necessarily solve all the barriers that will prevent you from getting these drugs, Chapman said.

Overall, this is a larger and more complex problem, and providing universal insurance coverage in isolation is unlikely to lead to future equitable access, he said.

Dr. Sahar Takkouche, chief medical officer at Vanderbilt Wilson County Hospital and a specialist in obesity medicine, said more obesity medicine doctors need to be trained so they feel comfortable discussing these drugs with their patients. patients

There’s a lot of misinformation out there, and there’s a limited amount of people who have the knowledge to be able to prescribe weight-loss drugs, he said.

This article was originally published on NBCNews.com

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