Anna Wilde Mathews
speaker
275 appearances
5 recordings
1 series
first heard Aug 2017
last heard Sep 2023
Anna Wilde Mathews’s voice in public audio — every appearance, attributed to the second.
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Appearances
you probably would be seeking Wigovi because often they're not going to give you the diabetes medications if you don't have diabetes.
And in that case, they'd be looking for things like whether you
meet the conditions that are spelled out in the label of WGOV.
So again, that would typically be having a BMI of 30 or higher or a BMI of 27 or higher along with a related health condition such as high blood pressure.
In addition, they're sometimes looking for other things like you've tried other efforts at weight loss, often through a structured program.
It depends on the health plan.
As we all know, any of us who've had more than one health plan knows it can be completely variable how much you have to pay out-of-pocket for the same treatment, depending on what employer you're with or what insurance plan you have.
but it can vary.
It can be just a flat comb payment like we often experience for drugs, but these are pricey drugs and employers are leery of the cost both of the drugs for each patient and the number of patients who potentially could be eligible for them at some point.
So we did hear anecdotally that some employers are starting to ratchet up the out-of-pocket cost for patients who are getting coverage for these drugs.
So instead of perhaps a flat copay,
a plan might ask you to pay a coinsurance, which means a percentage of the cost of the prescription.
Well, it's maybe too soon to tell.
One key thing to keep in mind is it's not just insurers, it's often employers.
So depending on the size of the employer, most large employers for sure
are self-insured, which means they do decide.
They'll decide what they cover and what they don't.
There are not federal regulations requiring that weight loss drugs be covered, so that gives flexibility.
We did hear that employees who are seeking these drugs and feel that they really need them and whose physicians feel they really need them, some do appeal to their employers and insurers saying, you know, I really need this and you need to cover it.
They ask for either a change in policy or for an exception for them.
Showing 141–160 of 275 · page 8 of 14
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