Expanding access to weight-loss medications could save thousands of lives each year

The findings highlight the critical need to remove existing barriers that hinder people’s access to effective weight loss treatments and hinder public health efforts to address the national obesity crisis, the researchers said. According to the US Centers for Disease Control and Prevention, approximately 74% of Americans are considered overweight, while approximately 43% of these individuals are considered obese.

The widespread impact of obesity on health is well documented. It worsens conditions such as type 2 diabetes, cardiovascular disease and certain types of cancer. But despite the serious consequences, the development and application of highly effective treatments for obesity are lacking. Recent developments in pharmaceutical interventions, in particular the introduction of glucagon-like peptide-1 (GLP-1) receptor agonists, such as Ozempic and Wegovy, and dual gastric inhibitory polypeptides and GLP-1 (GIP/GLP-1) receptor agonists, such as tirzepatide, have demonstrated substantial efficacy in weight loss. These medications have shown promise in clinical trials and are increasingly used for weight management.

In conducting their study, the researchers sought to quantify the potential mortality impact of greater access to these weight-loss medications. They integrated data on the mortality risk associated with different body mass index (BMI) categories, the prevalence of obesity, and current restrictions on access to medications due to high costs and insurance restrictions.

According to the findings, if access to these new drugs were expanded to all eligible individuals, the U.S. could see up to 42,027 fewer deaths annually. This estimate includes approximately 11,769 deaths among individuals with type 2 diabetes – a group particularly vulnerable to the complications of obesity. Even under current conditions of limited access, researchers predict that approximately 8,592 lives will be saved annually, especially among those with private insurance.

The study highlights a critical inequality in access to medicines. Currently, the high cost of these medications, which can exceed $1,000 per month without insurance, limits their availability. For example, Medicare — one of the largest insurance programs for older adults — does not cover these medications for weight loss, impacting many who could benefit from them. Medicaid coverage varies widely by state, and private insurance often imposes high deductibles and copays, further limiting access, the researchers said.

“Expanding access to these medications is not just a matter of improving treatment options, but also a critical public health intervention,” said Alison P. Galvani, one of the study’s corresponding authors and the Burnett and Stender Families Professor of Epidemiology (Microbial Diseases) at the Yale School of Public Health. “Our findings underscore the potential to significantly reduce mortality by addressing financial and coverage barriers.”

The study also examined how expanded access could affect different regions and socio-economic groups. States with high obesity and diabetes rates, such as West Virginia, Mississippi and Oklahoma, will benefit most from increased drug availability. In these areas, expanding access could lead to the largest declines in per capita mortality.

However, the study authors caution that while the potential benefits are significant, several challenges remain. The high price of these drugs is a significant barrier and there are concerns about the pharmaceutical industry’s profit margins. In addition, supply and production constraints continue to hinder widespread availability.

“Addressing these challenges requires a multifaceted approach,” says Dr. Burton H. Singer, PhD, another corresponding author of the study and adjunct professor of mathematics at the University of Florida’s Emerging Pathogens Institute. “We must ensure that drug prices more closely reflect production costs and increase manufacturing capacity to meet demand. At the same time, we must address the insurance and accessibility issues that keep many people from getting the treatment they need.”

The researchers also took into account the impact of socio-economic factors on the effectiveness of expanded access to medicines. They adjusted their estimates to account for income differences, and found that even with these adjustments, the potential for lives saved remains significant. The results suggest that improving access to these medications could reduce health care costs associated with obesity-related conditions and improve overall quality of life for many Americans.