10.25.2023 OMA Board Book

7173 S. Havana St #600-130 Centennial, CO 80112 P: 303.770.2526 | F: 303.779.4834 obesitymedicine.org

August 9, 2023

UC Health Dear UC Health Leadership:

The Obesity Medicine Association (OMA) is an organization of nearly 5,000 expert medical clinicians who treat the chronic and relapsing disease of obesity. One of the challenges our providers and their patients face is the lack of coverage for the treatment of obesity, inclusive of effective FDA-approved anti-obesity medications (AOMs) It has come to our attention that UC Health has been extremely forward thinking by providing coverage of AOMs for your employees over the last year but that your healthcare organization has recently decided to discontinue this coverage. This decision will significantly disadvantage those who are currently being treated successfully for obesity with AOMs in addition to future patients who could benefit from this key treatment intervention. Due to the chronic and relapsing nature of the disease of obesity, the majority of those people who are being treated will begin to have weight recurrence despite their best efforts with healthy nutrition and physical activity endeavors, to no fault of the patient(s). We understand that the GLP-1 agonist type AOMs, Wegovy (semaglutide) and Saxenda (liraglutide) are very expensive and likely the reason you are stopping coverage. However, it seems you are ‘throwing the baby out with the bath water’ by discontinuing coverage for all AOMs most of which are of reasonable cost. Sympathomimetics like phentermine and diethylpropion are generic and can be bought retail for $10-20 a month. Contrave (bupropion/naltrexone) and Qsymia (phentermine/topiramate) are also of reasonable cost and can be bought retail for $99 a month. Likely your pharmacy benefit manager would be able to do better than retail on pricing. We ask you to consider continued coverage for these less expensive AOMs and create a prior authorization process for the more expensive GLP-1 agonists for the patients with more severe obesity who are most in need, especially people with known cardiovascular disease given the recent announcement of the SELECT trial results. The SELECT trial is a pivotal trial that has shown a 20% reduction in MACE (major adverse cardiovascular events) in patients with obesity and a history of cardiovascular disease with obesity disease treatment with semaglutide. A recent study from the Obesity Action Coalition (OAC) recently showed that 44% of people would change jobs to get access to effective treatment for obesity. (https://ro.co/weight-loss/obesity-and-GLPs-survey/ ) Nurses have some of the highest rates of obesity and there is also a current labor shortage of nurses. This could create a costly unintended issue for your organization if you must pay for traveling nurses when you have those leave for other jobs. The American Medical Association (AMA) defined obesity as a chronic disease in 2013. Science has shown that obesity is not the liability of an individual’s lifestyle, but instead, obesity represents a complex and multi-factorial disease. Obesity has genetic origins with biological, environmental, and cultural influences which display differently in each patient. Obesity is costly and causes over 200 other medical conditions including diabetes, heart disease, depression, sleep apnea, osteoarthritis and several types of cancer. To that end, it is obvious that by treating obesity first, (the principal cause of these conditions), medical costs would be significantly reduced due to the prevention, improvement, or resolution of these related diseases. Treating obesity improves patients’ health, well-being, and quality of life. There isn’t another chronic disease that health plans are able to “carve out” or exclude from treatment coverage. We assume as a healthcare organization, your priority would be to ensure your own employees have optimal health and providing comprehensive obesity treatment is important to achieving this goal. Members of the OMA are powerful advocates for our patients. We work tirelessly to improve access to obesity treatments throughout the country at both the local (state) as well as federal levels. To that end, the OMA respectfully requests UC