Less than 1% of Military Health System beneficiaries use an obesity medication
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Key takeaways:
- According to a Defense Health Agency report, 30.5% of Military Health System beneficiaries have obesity.
- Obesity medications were prescribed to 0.56% of beneficiaries from October 2017 to September 2022.
Obesity medications were prescribed to very few Military Health System beneficiaries between October 2017 and September 2022, according to a study published in Obesity.
In a report to Congress from the Defense Health Agency, approximately 41.6% of Military Health System beneficiaries have overweight and 30.5% have obesity. However, data from the Military Health System Data Repository showed obesity medications were prescribed to 0.56% of beneficiaries aged 18 to 64 years.
“The rapid increase in the prevalence of overweight and obesity among U.S. service members, veterans and their families is posing a growing threat to both military readiness and the Department of Defense budget. Anti-obesity medications are significantly underutilized among Military Health System beneficiaries, including active-duty service members, despite insurance coverage since May 2018,” Taylor Neuman, MD, general internal medicine physician in the department of preventive medicine and biostatistics at Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center in Bethesda, Maryland, and colleagues wrote. “This suggests that the Department of Defense could significantly improve its use of this safe, effective and often critical medical treatment to limit the medical, military readiness and fiscal costs of overweight and obesity.”
Researchers conducted a cross-sectional study of adults aged 18 to 64 years who were TRICARE Prime and Plus beneficiaries from October 2017 to September 2022. Obesity medications in the study included phentermine alone, orlistat, bupropion/naltrexone, phentermine/topiramate, liraglutide (Saxenda, Novo Nordisk) and semaglutide (Wegovy, Novo Nordisk).
There were 4,414,127 beneficiaries in the study, of whom 7,496, or 0.56%, received an obesity medication. Obesity medications were prescribed to 1,792 active-duty service members.
The authors cited multiple factors for the low uptake of obesity drugs, including a shortage of obesity medicine physicians, a lack of training for physicians on treating obesity, a lack of access to comprehensive weight management programs and follow-up appointments with providers, explicit and implicit weight bias, and prior authorizations being required for obesity medications.
Among adults prescribed an obesity medication, the breakdown was as follows: liraglutide, 36%; phentermine/topiramate, 22%; bupropion/naltrexone, 19%; orlistat, 12%; semaglutide, 9%; and phentermine alone, 2%.
Women had higher odds for receiving an obesity medication than men. Adults aged 30 to 59 years were more likely to be prescribed an obesity medication than adults aged 20 to 29 years, whereas those aged 18 to 19 years or 60 to 64 years had lower odds for receiving an obesity medication. Asian and Pacific Islander adults were less likely to be prescribed obesity medication than white adults. Junior enlisted personnel, senior enlisted personnel and warrant officers were more likely to receive an obesity medication than senior officers.
“Moving forward, TRICARE should simplify the administratively burdensome step therapy process put in place for the coverage of anti-obesity medications,” the researchers wrote. “Second, the military services should agree on a uniform set of less-restrictive policies, which set clear guidance for the use of anti-obesity medications, including in special circumstances and occupations. Third, medical education regarding the comprehensive management of overweight and obesity must be improved, scaled, and spread across all trainees and current providers to reduce weight bias and increase access to care.”
Reference:
- Military Health System. Evolution of the TRICARE Program: Fiscal Year 2022 Report to Congress. https://www.health.mil/Reference-Center/Reports/2022/10/07/Evaluation-of-the-TRICARE-Program-FY-2022-Report-to-Congress. Published Feb. 28, 2022. Accessed Aug. 22, 2024.
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