Editor’s note: The attached comment letter was submitted to the Centers for Medicare & Medicaid Services (CMS) on Jan. 27, 2025.
Schaeffer Center Scholars submitted comments to CMS in response to the agency’s Nov. 26, 2024, proposed rule to broaden Medicare and Medicaid coverage of anti-obesity medications (AOMs). The researchers made the following points:
New policy interventions are needed: The societal burden of obesity is large and the status quo programs promoting diet and exercise alone have failed to impact rising prevalence rates. New policy interventions are needed to reverse obesity trends and to begin address the soaring rates of chronic disease in the U.S.
Treating obesity offers compelling returns on investment: Forthcoming research from USC Schaeffer Center estimates the lifetime social returns to broader AOM treatment for various age and health-risk groups. We find that, after accounting for treatment costs, total lifetime net social value is positive for all patients with obesity and the estimated social returns from investing in AOMs exceed other private and public uses of capital recognized as valuable.
Cost-offsets from Medicare coverage of AOMs may exceed current estimates: AOM policies adopted by CMS could influence coverage decisions in the private insurance market which would generate future cost offsets for Medicare by improving the health of cohorts entering Medicare. Several prominent budget impact estimates, such as the Congressional Budget Office’s, abstract away from these potential effects. Broad coverage of AOMs for patients before they enter Medicare would prevent or delay chronic conditions like diabetes, heart disease, and cancer where the costs largely accumulate later in life.
Broad access to AOMs will shrink existing health disparities: Obesity disproportionately impacts Black and Hispanic beneficiaries, as well as individuals with lower income and less education. Additionally, research shows that these under-represented minority communities lose less weight with behavioral interventions. At the same time, economically disadvantaged individuals receive less access to behavioral weight-loss interventions. This means that the status quo – limited access to AOMs – coupled with continued focus on behavioral interventions will likely widen existing disparities in obesity and related comorbid diseases like diabetes, hypertension, heart disease, lung disease, cancer and stroke.
Read the full comment letter here.