Expanding access to weight loss drugs could save tens of thousands of lives each year

Key takeaways:

• The current uptake of weight loss drugs would reduce deaths by 8,592 annually.
• Expanded access to weight loss medications could reduce the prevalence of obesity.

Expanding access to weight loss medications could save tens of thousands of lives annually, according to an analysis published in PNAS.

Medications like semaglutide (Wegovy/Ozempic, Novo Nordisk) and tirzepatide (Mounjaro, Zepbound) “have demonstrated remarkable efficacy in clinical trials, resulting in weight reductions previously considered unattainable through pharmaceutical means alone,” Abhishek Pandey, PhD, a research scientist in epidemiology at Yale School of Public Health, and colleagues wrote.

The drugs’ effectiveness for obesity treatment has resulted in their usage soaring over the past couple of years, but their accessibility is significantly impacted by factors like supply shortages, high costs and a lack of insurance coverage.

Specifically, costs of weight loss drugs can range from around $900 to $1,000 or more, whereas Medicare does not cover the medications solely for weight loss, which may affect older patients who could benefit from them, the researchers noted.

“The cost barrier is further compounded by the ongoing need for these medications, as discontinuation often leads to weight regain, necessitating a long-term financial commitment from patients,” they wrote.

In the analysis, Pandey and colleagues determined the potential reduction of deaths in the United States that would result from expanded weight loss drug access by using established associations between BMI and mortality risk and obesity prevalence data.

They estimated annual decreases in mortality under two scenarios: the current uptake of weight loss medications and expanded access. In the latter scenario, “we take into account that drug uptake is contingent upon eligibility, the ability to obtain health care services and individual willingness to take the medication,” the researchers noted.

They found that the total number of deaths would be reduced by 8,592 yearly at the current uptake level (95% uncertainty interval [UI], 8,580-8,604), with 71% of these deaths being individuals with private insurance.

Under expanded access, the number of reduced deaths would rise to 42,027 annually (95% UI, 41,990-42,064), 11,769 of which would be individuals with overweight and type 2 diabetes (95% UI, 11,707-11,832).

Additionally, the prevalence of obesity would decline from 42% to 38%.

Pandey and colleagues also adjusted individuals’ mortality reduction based on their income to account for socioeconomic factors.

This adjustment led to 32,906 fewer deaths annually under expanded access (95% UI, 32,875-32,938).

However, as many as 165,574 lives (95% UI, 165,421-165,727) could be saved yearly “under the optimistic scenario of willingness and adherence,” the researchers wrote.

They pointed out that they did not account for how obesity-related mortality might differ in the presence of factors like lifestyle modifications or prevention-based interventions.

“The availability of comprehensive weight management programs that integrate prevention-based approaches with access to these drugs could be the most effective strategy to mitigate the repercussions of obesity,” they suggested. “Such programs may also mean that not all eligible individuals would need to be on the drugs.”

The researchers concluded that the information “underscores the urgency of addressing access barriers, including affordability, insurance coverage and prescriber awareness.”

“Such policies could galvanize a new era of American well-being and prosperity,” they wrote.