Expanding Access to Fight the Obesity Epidemic

Access is always a big topic for us. So how can access to these weight loss drugs help the obesity epidemic that not only the US is facing, but the world?

You hit the issue. The issue isn't that we don't have medications available today. The issue is that we have chosen not to make them accessible for the average patient. If you have a Cadillac health plan, or you're very wealthy, you can get all the care you need. But if you are the normal person out there suffering from obesity, the coverage is blocked. And it's blocked at the government level, and it's blocked at the commercial level. And that's incredibly frustrating knowing the toll that obesity is taking on the on the patients within our healthcare system, and on the financials within our healthcare system. The collateral damage that obesity does to the body, in every other disease state is more than any, any other any other disease. And so, attacking the top of the pyramid is what we have to do, we can't do it if access is blocked. And we've seen a couple of examples here of I think, companies moving forward in this in this regard.

First is in Europe, they have been, you know, three to four years ahead of us and treating obesity, and they've gone through a number of different reimbursement schemes. And for the countries that are covering obesity, they are they are they're sophisticated now after years of trying. And so, you see certain companies covering by phenotype, meaning pairing the right medication to the right patient, what determining what is driving that patient's disease and making sure they get the medication that's best suited to attack that underlying driver first, so there's not money wasted in the system. You see other company, other countries that have just focused more on the dollars where they want you to start with the least expensive medications before you start bringing onboard the more expensive medications in the US, we would call that step therapy.

In the US, we've seen a couple things. First, we've seen some of the closed healthcare systems offer all the products, but then do so in a way that is kind of a value-based system so that physicians know the price of the products that they're prescribing and can make good financial decisions at the same time, they're making good health care decisions. And those usually lead to great outcomes because every product is available. And there's one size, if there's one thing to take away is that one size does not fit all patients suffering from obesity, not a there's no chance that a single product is going to be a magic bullet that is going to solve obesity because obesity is a chronic multifactorial disease. That is when required, not just the products and the classes that we have in the market today. But a lot more in the future. And that's what we need.

We've seen, I think we've seen one real case of failure. And this is a very sad situation. In North Carolina, they made a great decision to start covering their state employees for obesity, for obesity care. And unfortunately, the I would assume the PBM that was associated with the employee’s coverage in their manufacture that was tied to the PBM offered discounts or rebates that were so attractive that they only allowed one or two medications to be used. And they were both the most expensive medications. Right. So, when you only have a will go up on formulary. One, you can't adequately, adequately treat the disease, because you need multiple classes and two, you're treating with by far the most expensive medication on the market. That's we've just as a society as a country, we've never taken that approach. We've never said, let's start with the most expensive medication and disease. And at the same time, let's exclude all of the least expensive medications that are in different classes that treat a different way. And we try that here in North Carolina for whatever reason, it failed miserably because North Carolina woke up and said, this is $100 million. One, we can't afford this, and two, we're going to pull back obesity coverage for all of our all of our state employees, and now they have access to a handful of older medications and maybe you know, one of the other controlled substances. But by and large, you know, we've got a situation where, you know, the wrong treatment scheme was used, cos ran while as a result, patients with obesity really don't have the coverage they need any longer in North Carolina. And that's, we can't make that mistake at a national level.