George Hampton, CEO of Currax Pharmaceuticals, joins TheStreet to explain what needs to happen in order for weight loss drugs to become covered by insurance companies.
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00:00What is it going to take to change that scenario in terms of major health coverage for these anti-obesity drugs?
00:10Well, we're trying every day. We spend a lot of time in D.C. We're working on a bill that we call TROA, the Treat and Reduce Obesity Act,
00:17and I think it has incredible promise and it could even be passed this year.
00:21We have a lot of support from all the senators and all the congresspeople.
00:25It just comes down to being able to pay for it along the way in the budget.
00:28So, from your viewpoint, what exactly is the issue?
00:32Do they feel like the drugs are too new and unproven for them to put their backing or their money to cover it?
00:40Like, what's the issue?
00:42It's the budget. It's how much money do we have to cover obesity and what will it cost?
00:46And so, the Congressional Budget Office has recently released its estimate of what it will cost the country to pay for that.
00:52It was a very low number compared to what people were estimating.
00:56And so, we're very encouraged that this could happen this year before the end of the year.
01:00So, do you need the government health insurance plans to start paying in order for the private health insurers to get on board?
01:12It's like a chicken and egg kind of thing.
01:14It is to some degree. And so, the government, for example, when they start paying for something, the commercial plans often feel compelled to do the same.
01:22But it's not 100%.
01:24And so, you think of in smoking cessation back in 2010 under the ACA, a group was finally able to be paid for by the government and the commercial payers followed right along.
01:34And we think the same thing will happen here with weight loss.
01:38Is it all about lobbying? What does the industry have to do to convince the healthcare insurance industry and the government, for that matter, to stop paying for it?
01:54I know. It's so frustrating.
01:55Or is it just because there's so many obese people and they look at the numbers and they're like, oh, we don't have the money for that. Is that what it is?
02:04To some degree. You have to go all the way back. A little bit of history.
02:06You have to go all the way back to 2002 when Medicare Part D first came into play under Bush II.
02:13At that time, there were certain medications and certain classes of medication that were carved out.
02:19ED products, aesthetic products, smoking, weight loss.
02:24They were all carved out as more lifestyle diseases.
02:28And so, they weren't covered.
02:30Going forward, we know that we need to cover it because we've ignored this obese population.
02:34We haven't always been, as a population, 43% obese across the United States as adults.
02:40We've ignored the problem. We have not intervened like we have with every other chronic disease.
02:45And therefore, the disease has kind of run its course.
02:49And we see it everywhere.