This week we have some interesting news about medications for obesity and their effects on diabetes. Our first article looks at the use of orlistat and lorcaserin and how waist circumference is affected while another article from EASD Barcelona examines the use of naltrexone and buproprion.
The problem with all of these ideas is the availability of these medications for the majority of our patients. For the past few years prescription coverage for any medication for weight loss has been nonexistent at best and as we have seen over the past 6-9 months there has been a real tightening in the coverage for medications for chronic conditions such as diabetes, hypertension and lipidemia. Newer brand name medications have not received wide formulary coverage and many of our insurance plans are now advising prescribers to select older less effective but inexpensive medications for chronic conditions. Although the new rating systems that the Affordable Care Act (see our Homerun Slides for more information) has brought into place over the past 2-3 years leans toward payers realizing the value of some of the newer medications it remains to be seen whether they will decide that the cost of these therapies will be negated by the increased rewards they will receive.
Dave Joffe, Editor-in-chief