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Open Access 01-07-2015 | Current Opinion

The Challenges and Opportunities Associated with Reimbursement for Obesity Pharmacotherapy in the USA

Authors: Charles Baum, Katherine Andino, Eric Wittbrodt, Shelley Stewart, Keith Szymanski, Robin Turpin

Published in: PharmacoEconomics | Issue 7/2015

Abstract

Obesity has become a serious public health problem that has stimulated primordial and primary prevention efforts, and a triad of management options (lifestyle, pharmacotherapy, and surgical interventions). A growing body of evidence supports the need for a multi-pronged, clinic-based approach that leverages the synergy between pharmaceutical and lifestyle modification. Recent US policy changes—namely, the passage of the Patient Protection and Affordable Care Act coupled with recognition of obesity as a disease by the American Medical Association—suggest that financial incentives and attitudes towards obesity management are changing. This paradigm shift has implications for current and future obesity pharmacotherapy. However, barriers to pharmacotherapy utilization include patient and physician perceptions of modest efficacy, historical safety issues, regulatory obstacles, and lack of reimbursement. The shifting attitudes and challenges associated not only with a multi-payer system, but also the lack of clearly defined cross-payer reimbursement strategies, prompted a survey to determine coverage for obesity treatment. Participants indicated that federal/state mandates and growth of quality-driven healthcare initiatives will eventually drive wider pharmacotherapy reimbursement within 1–5 years. There are signs that federal/state programs are already moving towards reimbursement by improving quality measures to track obesity outcomes and reduce costs. Future research on clinical and economic outcomes of combination weight-management programs coupled with innovative approaches (e.g., eHealth) in the real-world setting that demonstrate value to patients, healthcare providers, payers, and employers will help reshape obesity management by reducing barriers and broadening reimbursement coverage for anti-obesity pharmacotherapy.

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Title: The Challenges and Opportunities Associated with Reimbursement for Obesity Pharmacotherapy in the USA
Authors: Charles Baum
Katherine Andino
Eric Wittbrodt
Shelley Stewart
Keith Szymanski
Robin Turpin
Publication date: 01-07-2015
Publisher: Springer International Publishing
Published in: PharmacoEconomics / Issue 7/2015
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI: https://doi.org/10.1007/s40273-015-0264-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Challenges and Opportunities Associated with Reimbursement for Obesity Pharmacotherapy in the USA

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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Obesity in the Context of Aging: Quality of Life Considerations

Savings in Medical Expenditures Associated with Reductions in Body Mass Index Among US Adults with Obesity, by Diabetes Status