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Seeking Medicare coverage for weight loss drugs, pharma giant courts Black influencers

August 11, 2023
in Lifestyle
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Pharmaceutical big Novo Nordisk has turned to influential Black Individuals in pursuit of what can be a profitable victory: having Medicare cowl a brand new class of weight reduction medicine, together with the corporate’s extremely sought Wegovy, which may value sufferers greater than $1,000 a month.

Picture: AdobeStock

Throughout a convention of the Congressional Black Caucus Basis final fall — a jampacked gathering that includes outstanding Black lawmakers and President Joe Biden — Novo Nordisk sponsored a panel dialogue on weight problems for which it chosen the moderator and panelists, firm spokesperson Nicole Ferreira stated. The muse is a nonprofit affiliated with the Congressional Black Caucus, a strong group of lawmakers on Capitol Hill.

Former CNN political commentator Roland Martin moderated. Black well being consultants who assist Medicare protection of medication used to deal with weight problems served on the panel. They included Fatima Cody Stanford, an affiliate professor of drugs at Harvard Medical College. Stanford is a specialist in weight problems who has obtained consulting charges from Novo Nordisk.

Through the panel dialogue, Stanford instructed the viewers that weight problems “is an actual illness that individuals battle with,” she recounted in an interview with KFF Well being Information. “We’ve denied individuals look after weight problems after we haven’t for different persistent illnesses.”

Novo Nordisk, the main maker of so-called weight problems medicine, adopted up on the September panel by sponsoring a streaming present in March hosted by Martin, throughout which friends advocated for Medicare to cowl medicine for weight reduction. Ferreira stated the corporate advised consultants for the section, however she didn’t title them.

These actions are a part of a broader Novo Nordisk marketing campaign to shift the general public narrative about weight problems. They open a brand new window on drugmakers’ efforts to affect shoppers and public coverage.

Novo Nordisk is attempting to reverse a 20-year-old ban on protection of medication used for weight reduction underneath Medicare, the federal medical insurance program primarily for individuals 65 and older. Congress excluded such drugs when it established Medicare’s Half D prescription drug profit in 2003. The ban successfully deprives drugmakers of tens of millions of potential prospects.

Can Wegovy save lives? Study reveals weight-loss drug reduces heart attack and stroke risks

Increasing the Affected person Pool

Medicare protection would put weight problems medicine inside attain of many individuals who couldn’t in any other case afford them. It might have a multiplier impact as a result of non-public insurers typically comply with Medicare’s lead.

It will be a monetary boon to Novo Nordisk and different drugmakers, together with Eli Lilly, which is searching for FDA approval for a weight reduction drug.

Including to the associated fee and the potential upside for the business: To maintain weight off, sufferers might need to take the medicine indefinitely.

Wegovy’s record worth is about $1,350 for roughly a month’s provide. Eli Lilly’s Mounjaro, a drug for individuals with Sort 2 diabetes that docs prescribe off-label for weight problems, is priced at about $1,023 for roughly a month’s provide.

Wegovy is FDA-approved for weight reduction in adults who’ve a physique mass index of 30 or larger — the definition of grownup weight problems, in line with the Facilities for Illness Management and Prevention — or a BMI of a minimum of 27 plus a minimum of one weight-related medical situation, equivalent to hypertension. It’s additionally accredited for sufferers as younger as 12 who’re deemed overweight.

In a press release, Novo Nordisk spokesperson Allison Schneider stated, “We advocate for sufferers and insurance policies that assist entry to all weight problems remedies, together with protection for anti-obesity drugs in Medicare Half D.”

The corporate helps the Deal with and Scale back Weight problems Act, laws launched in 2013 that will overturn the Medicare protection ban. In July, a bipartisan group of lawmakers within the Home and Senate reintroduced the invoice — one thing lawmakers have carried out repeatedly over the last decade.

Drug firms have lengthy used a wide range of methods to advance company pursuits, equivalent to funding so-called affected person advocacy teams centered on particular illnesses and airing direct-to-consumer advertisements that spur sufferers to ask their docs about brand-name medicine.

Novo Nordisk is the most important company donor to the Weight problems Motion Coalition, which says its mission is “to raise and empower these affected by weight problems.”

Novo Nordisk contributes greater than $500,000 yearly to the group, in line with its web site. The group’s legislative aims embody reversing Medicare’s protection ban on weight reduction medicine.

The Weight problems Motion Coalition “just isn’t influenced in any method by our huge array of supporters,” stated Kendall Griffey, a spokesperson for the group.

Novo Nordisk has marketed Wegovy, which the FDA accredited for weight reduction in 2021, and Ozempic, which is accredited for diabetes and prescribed off-label to deal with weight problems.

Like many massive companies, Novo Nordisk has contributed 1000’s of {dollars} yearly to nonprofits tied to completely different teams of lawmakers whereas searching for assist in Congress for its causes.

In 2021, Novo Nordisk gave between $100,000 and $399,999 to the Congressional Black Caucus Basis and between $25,000 and $49,999 to the Asian Pacific American Institute for Congressional Research, in line with every nonprofit’s annual report.

The latter nonprofit, generally known as APAICS, is affiliated with the Congressional Asian-Pacific American Caucus. APAICS lists Novo Nordisk as a accomplice on webpages for occasions in March and Might the place panel discussions touched on the therapy of weight problems.

The Congressional Hispanic Caucus Institute additionally lists Novo Nordisk as a donor however doesn’t state how a lot the corporate contributed.

The Congressional Black Caucus, Congressional Hispanic Caucus, and Congressional Asian Pacific American Caucus again a invoice on well being disparities that in 2022 was revised to scrap Medicare’s prohibition on overlaying prescriptions for weight reduction.

The Congressional Black Caucus Basis, the Congressional Hispanic Caucus Institute, and the Asian-Pacific American Institute for Congressional Research didn’t reply to questions for this text. Novo Nordisk declined to say how a lot it contributed to the Congressional Black Caucus Basis’s 2022 legislative convention and whether or not it sponsored the panel to affect Congressional Black Caucus members’ positions; it equally declined to specify its most up-to-date annual contribution to the Congressional Hispanic Caucus Institute and its monetary contributions for numerous APAICS occasions this 12 months. “We assist a number of organizations to assist educate on and spotlight points vital to their communities,” firm spokesperson Natalia Salomao stated of Novo Nordisk’s relationship with the nonprofits.

Excessive-Profile Promoters

Martin’s streaming every day information present in March featured an hourlong section “powered by Novo Nordisk” on weight problems amongst Black Individuals. Ferreira of Novo Nordisk stated Martin and Novo Nordisk “agreed {that a} section on his present was alternative to achieve his viewers to assist additional inform them about weight problems as a persistent illness and the significance of excellent vitamin and well being care.”

Martin didn’t reply to requests for remark. Through the episode, he cited Novo Nordisk’s function. “I definitely wish to thank them for partnering with us,” he stated.

Friends pushed for Medicare to cowl sufferers’ anti-obesity prescriptions, with a watch towards what protection might imply for seniors and different adults. The federal authorities is “alleged to be main the way in which on this,” Nelson Dunlap, vice chairman of public coverage and exterior affairs for Meharry Medical Faculty, a traditionally Black establishment, stated in the course of the section.

“Industrial insurances are likely to comply with what Medicare does,” Tiffani Bell Washington, a psychiatrist specializing in weight problems medication, stated on the present. Weight problems is “a well being concern. So it actually does have to be coated, and if Medicare covers it, normally different individuals comply with.”

Dunlap declined to remark for this text, and Bell Washington didn’t reply questions despatched by electronic mail.

Novo Nordisk enlisted Black music and leisure stars Queen Latifah and Yvette Nicole Brown to be paid spokespeople for an academic marketing campaign that started in 2021, speaking that weight problems is a persistent illness and ought to be handled like different illnesses. Each celebrities have overtly talked about dwelling with weight problems.

Stanford, one of many contributors within the September panel, in 2022 obtained $23,188 from Novo Nordisk, practically double what she obtained from the corporate in 2021, federal information present. The 2022 funds embody consulting charges and bills for meals and journey.

“I wouldn’t need somebody that has no information informing them on how this really works in actual life,” Stanford stated, explaining her relationship with the businesses. “The individuals they be taught from are individuals like me, the individuals that really do that work on the bottom on daily basis with sufferers.”

Ozempic? Wegovy? Mounjaro? Here’s the skinny on the latest weight loss drug craze.

One other panelist was Eric Griggs, an assistant vice chairman at Entry Well being Louisiana, a community of federally certified well being facilities. In an interview, Griggs stated Medicare protection of weight problems medicine “would assist the answer. Should you can assist one group, you possibly can assist all of them.”

In response to the Facilities for Illness Management and Prevention, based mostly on BMI, 50% of non-Hispanic Black adults within the U.S. are categorized as overweight, the highest price for any race or ethnicity.

Nevertheless, the BMI measurement has more and more come underneath criticism as flawed. In June, the American Medical Affiliation stated it “doesn’t account for variations throughout race/ethnic teams, sexes, genders, and age-span.”

Since 2014, Novo Nordisk has spent greater than $30 million lobbying members of Congress and different federal officers, in line with a KFF Well being Information overview of lobbying disclosures. A constant topic is the Deal with and Scale back Weight problems Act.

“We now have huge healthcare challenges that stream from weight problems,” stated Sen. Tom Carper (D-Del.), a lead sponsor of that laws. He argued that spending cash on weight reduction medicine would scale back spending on persistent illnesses that drive up the federal authorities’s well being care tab.

Carper is a longtime recipient of marketing campaign money from drug firms, together with makers of weight reduction medicine. Nevertheless, some researchers categorical warning about lifting Medicare’s protection ban. For seniors, the unwanted side effects of such medicine could possibly be extra harmful, in line with a paper by students  at Vanderbilt College and the College of Chicago.

Unintended effects for Wegovy and Ozempic might embody kidney issues, gallbladder illness, irritation of the pancreas, and thyroid most cancers, in line with the product labels. Suicidal ideas are listed as a doubtlessly critical aspect impact of Wegovy, its label says.

The Vanderbilt and Chicago researchers discovered that, even with modest uptake of the drugs, annual Medicare Half D bills might improve by $13.6 billion. That might depart policymakers “within the place of creating broad cuts to different kinds of care,” stated Khrysta Baig, one of many paper’s authors.

However individuals who need Medicare and different insurance coverage applications to cowl the medicine emphasize potential benefits.

Protection would save “the lives that we’re shedding at early ages, particularly within the Black neighborhood,” Bell Washington stated on Martin’s present in March earlier than calling on viewers to take motion. “It is advisable to write to your legislators, ensure you’re selecting people who find themselves in assist of well being look after all,” she stated.

KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is likely one of the core working applications at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Be taught extra about KFF.

TheGrio is FREE in your TV by way of Apple TV, Amazon Fireplace, Roku, and Android TV. TheGrio’s Black Podcast Community is free too. Obtain theGrio cellular apps as we speak! Hearken to ‘Writing Black‘ with Maiysha Kai.



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