GPBCH Speakers Support Potential Benefit Design for Obesity

Data published at the Greater Philadelphia Business Coalition on Health (GPBCH) show epidemiological and economic trends in obesity, treatment and lifestyle options, and how benefit designs help providers manage obesity as a chronic disease. I have outlined what is useful for.

Novo Nordisk’s Medical Accounting Associate Directors, Niki Patel, PharmD, and MBA, began by discussing the causes of obesity and the impact of weight loss on health outcomes.

About 42% of adults in the United States are obese, and that percentage is expected to reach 50% within the next decade. According to Patel, the main problem with obesity is that it is not managed as a chronic disease. Social determinants of health also influence the prevalence of obesity, which increases with the cost of illness.

“Currently, two in five white adults are obese, while one in two black adults is obese, but black patients diagnose and treat obesity more than white patients. It’s less likely to get it, and even fewer people actually get treatment, “Patel said.

Patel further explained that dietary changes are the main reason for the high obesity rate in the United States. In particular, the amount increases over time and access to foods with health problems is easy. From the 1950s to the 2010s, the average restaurant meal size quadrupled, and the average adult in the United States weighed 26 pounds.

Stress, sleep deprivation, and inactivity are also major lifestyle factors contributing to the obesity epidemic in the United States and genetic factors such as epigenetic modifications. GPBCH President and CEO Neil Goldfarb presents data from a study of weight changes during the COVID-19 pandemic, showing how the pandemic affected these lifestyle factors and caused unwanted weight changes. I pointed out.

According to data from the American Psychological Association, which stratified people by gender, race, and age, the proportion of people who reported unwanted weight gain during a pandemic was overall compared to those who reported unwanted weight loss. It was expensive. In general, 61% of US adults in this study reported unwanted weight changes during a pandemic.

“The impact of an already prevalent pandemic on obesity is so significant that we think this is a more important topic than ever,” said Goldfarb.

Digging deeper into strategy and clinical outcomes, the speaker said that obese people can experience significant benefits even if they lose a small percentage of their weight. The data showed improved results in the following comorbidities by the percentage of weight loss:

• 0% -5%; hypertension, hyperglycemia

• 5% -10%; Polycystic ovary syndrome, dyslipidemia, type 2 diabetes (T2D) prevention, asthma, atopic dermatitis, non-alcoholic fatty liver disease
• 10% -15%; Urinary stress incontinence, obstructive sleep apnea, gastroesophageal reflux disease, knee osteoarthritis, cardiovascular disease, non-alcoholic steatohepatitis
• Over 15%; Heart failure with maintained T2D remission, cardiovascular mortality, and ejection fraction

Dr. Anastasia Amaro, Dean of Medicine at the University of Pennsylvania and Dean of Medicine at the University of Pennsylvania, explained how to help obese people lose weight. One strategy is a step-by-step approach that begins with lifestyle changes and moves to medication and weight loss endoscopy. She discussed in detail the challenges of getting patients to start dosing to treat obesity.

Obesity drugs are a difficult sale for some doctors, she said. They may have “therapeutic pessimism” because they tried treatment in the past but later withdrew from the market. And getting the drug approved by the insurance plan is a process.

“I have an assistant who calls the insurance company to find out what’s covered,” Amaro said. “What are the pre-approval conditions to cover the drug? So the work is done before discussing the drug … That is, these are the numbers for a single patient-doctor intervention. It’s a task of time. “

Patients at her center have access to clinical trials, and some patients receive FDA-approved Novo Nordisk glucagon-like peptide 1 receptor agonist semaglutide 2.4 mg (Ozempic). I was able to participate in the exam. She stated that the patient’s average weight loss was equal to or greater than the 12.4% weight loss for the entire study.

“If we have access to this drug, we are confident that we can actually reproduce it,” she said.

If medication is ineffective for some reason, the patient is a candidate for weight loss surgery. However, weight loss surgery is not a permanent solution for everyone.

“At this point, we already know that about 30% of people with a history of weight loss surgery will regain some or all of the weight they lost in obesity surgery,” Amaro explained. “So the new type of patients we see in our clinic are post-operative weight recovery patients, we prescribe medications, voluntary and professional lifestyle changes and diet and exercise counseling. Must be done. “

Amaro also suggested a more cyclical approach, saying that obese people can be treated at any time and can “enter” or “exit” the circle at any time. Common phases within the circle include assessing obesity, interventions for severe weight loss, interventions for maintaining weight loss, and prevention of weight gain or recovery.

Goldfarb concludes the seminar by explaining what should be included in a comprehensive profit design for obese people.

• Prevention and promotion of a healthy lifestyle
• Case identification and data management
• Provider network support and referral
• Mental health service support
• Pharmacological benefits including the scope of anti-obesity drugs
• Surgical benefits
• Recognition of social determinants of health and fairness of health
• Follow-up support

“We don’t want doctors to prescribe that they have cured obesity or played their part,” Goldfarb said. “We want to make sure that doctors are actively monitoring patients.”