Another Day, Another Set of Questions About Obesity-Med Coverage

Every day, I say: this is the day I’ll stop writing about obesity.

And every day, at least for about the past week, I break that promise to myself.

And I’m going to do it again, for four reasons:

1. My favorite newsletter, Money Stuff, which is not about health and rarely dives into my world, touched on the broader impact of obesity meds yesterday. It’s a think piece about what stock ownership really means in a world of diversified, interlinked mutual funds, but at least it’s something different.

2. There is this survey of employers, from the folks at Accolade, which says that 43% of employers are planning to cover obesity meds next year, up from 25% this year. I’m not deep in the numbers enough to officially roll my eyes, but that feels, um, optimistic. I know that employees will want that as a benefit, but there are some other pressures employees will be feeling. (More than below.)

3. North Carolina says that covering obesity for state employees has been a bit of a fiscal disaster (“financially under siege” is the technical term the state is using).

4. But Connecticut is optimistic about its new plan to cover the drugs because the effort will be paired with a requirement for lifestyle management.

I’m not sure there’s anything solid to take away (unless you trust the Accolade numbers), beyond a reminder that this will be the defining drug-price-and-reimbursement issue of the next five years.

It’s a short arc today, but I want to make sure that I’m putting a flag down: we’re about the enter a cycle in which we hear a lot about health insurance: how much it will cost next year, what it will cover, and how much the health insurance companies are making.

UnitedHealth Group will drop earnings on Friday. I haven’t looked at analyst expectations, but -- I assure you -- the profit numbers will be boffo. Because the profit numbers are always boffo.

At the same time, consumers should expect some sticker shock as open enrollment approaches. The Federal Employees Health Benefits program has already warned beneficiaries that premiums will jump by an average of 5.8% (and the employee contribution will be up more like 7.7%).

STAT’s Bob Herman put that in context: “If you are a federal employee, and your pay raise for 2024 is less than the increases to your health insurance, you are taking a pay cut.”

And we’re within a month of KFF dropping its 25th annual Employer Health Benefits Survey, which will document just how bad insurance coverage is becoming.

Will anyone connect all of this and ask exactly why benefits are getting worse, premiums are getting higher, and health insurers are making money hand over fist?

I hope so!

Extra quick, given the lateness of the hour:

• Sen. Bernie Sanders is going after non-profit hospitals in a new report. Lots of detail on charity care levels. 340B isn’t mentioned.

• Boehringer Ingelheim isn’t changing its R&D approach in response to the IRA … yet, per this STAT interview with BI’s Michel Pairet.

• Kentucky did away with PBMs … and is profiting.

• Axios breaks down the Novo Nordisk lawsuit claim that “drug” doesn’t mean what CMS thinks it means.