Obesity has become a major health concern in the United States, with over 42% of adults considered to be obese. Obesity increases the risk of developing several chronic conditions such as diabetes, heart disease, and stroke. Losing weight can help prevent or manage these conditions but can often be difficult through lifestyle changes alone. Prescription weight loss drugs can be an effective tool in aiding weight loss, but they can also be expensive. In this article, we will explore which weight loss drugs are covered by insurance.
Why Are Some Weight Loss Drugs Covered by Insurance?
In recent years, there has been an increase in the prevalence of obesity-related health problems, leading to higher healthcare costs. The cost of treating patients with obesity-related conditions is estimated to be $147 billion annually. To combat these rising costs, insurance companies have started covering weight loss medications that have been approved by the Food and Drug Administration (FDA).
The FDA approves weight loss medications based on their safety and efficacy. Clinical trials determine whether the medication aids in weight loss and if it has any adverse side effects. Once it is approved by the FDA, insurance companies may decide to cover the drug if it meets their criteria for safety, efficacy, and cost-effectiveness.
Types of Weight Loss Drugs
There are three types of weight loss drugs that are currently approved by the FDA: appetite suppressants, lipase inhibitors, and combination drugs.
1.Appetite Suppressants
Appetite suppressants work by reducing hunger and increasing the feeling of fullness. They do this by targeting neurotransmitters in the brain that control appetite. Phentermine is the most commonly prescribed appetite suppressant and has been approved for short-term use only.
2.Lipase Inhibitors
Lipase inhibitors work by blocking the absorption of dietary fat in the gastrointestinal tract. Orlistat is the only FDA-approved lipase inhibitor available in the United States.
3.Combination Drugs
Combination drugs are a combination of appetite suppressants and lipase inhibitors. They work by reducing hunger and blocking the absorption of dietary fat. The most common combination drug is phentermine/topiramate.
Which Weight Loss Drugs are Covered by Insurance?
Insurance coverage for weight loss drugs varies between insurance providers. However, there are some medications that are commonly covered by most insurance companies.
1.Orlistat (Xenical)
Orlistat is a lipase inhibitor that works by blocking the absorption of dietary fat in the gastrointestinal tract. It has been approved by the FDA since 1999 and is available only with a prescription. Orlistat is widely covered by insurance companies, although it may require prior authorization.
2.Phentermine
Phentermine is an appetite suppressant that has been approved by the FDA since 1959 and is available only with a prescription. It is typically prescribed for short-term use to aid weight loss in people who are obese or overweight. Phentermine is also widely covered by insurance companies, although it may require prior authorization.
3.Phentermine/Topiramate (Qsymia)
Phentermine/topiramate is a combination drug that works by reducing hunger and blocking the absorption of dietary fat. It has been approved by the FDA since 2012 and is available only with a prescription. While Qsymia is covered by many insurance companies, it may require prior authorization.
4.Liraglutide (Saxenda)
Liraglutide is an injectable medication that works by mimicking the effects of a hormone called glucagon-like peptide-1 (GLP-1) in the body. GLP-1 helps regulate appetite, and liraglutide has been shown to reduce hunger and promote weight loss. It has been approved by the FDA since 2014 and is available only with a prescription. Saxenda is covered by most insurance companies, although it may require prior authorization.
5.Naltrexone/Bupropion (Contrave)
Naltrexone/bupropion is a combination drug that works by reducing hunger and blocking the reward pathways in the brain that contribute to overeating. It has been approved by the FDA since 2014 and is available only with a prescription. Contrave is covered by many insurance companies, although it may require prior authorization.
Are Weight Loss Drugs Right for You?
Weight loss drugs can be an effective tool for aiding weight loss, but they are not suitable for everyone. They should be used in conjunction with lifestyle changes such as a healthy diet and regular exercise. Before starting any weight loss medication, it is important to talk to your doctor and determine if it is safe for you.
Weight loss drugs may not be suitable for those who have a history of heart disease, stroke, or uncontrolled high blood pressure. Additionally, some weight loss drugs can interact with other medications, so it is essential to inform your doctor of any medications you are currently taking.
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