Access to Obesity Medications Shouldn’t Be This Hard
Recent changes in insurance coverage have forced thousands of Americans living with obesity into an impossible choice: stop taking a safe, effective medication recommended by their health care provider—or pay out of pocket to continue their treatment.
That’s not right.
Access to obesity management medications has always been a challenge. These abrupt coverage changes only make it harder, undermining the care plans developed between patients and their providers.
When insurers and pharmacy benefit managers (PBMs) make decisions about obesity treatment coverage, it can:
- Disrupt ongoing care for patients.
- Prevent providers from prescribing the most effective treatments.
- Leave people with related conditions, such as obstructive sleep apnea, without any viable or affordable options.
Unfortunately, these issues go beyond recent coverage shifts. For example:
- Medicare doesn’t cover any obesity management medications.
- Only a few states include these treatments in their Medicaid programs.
- Even when a PBM adds a medication to its formulary, employers often still have to opt in—many don’t.
This isn’t just about one medication, insurance plan, or PBM. It’s about a broken system that restricts access to care and puts unnecessary barriers between people and the treatments they need.
At Lilly, our mission is to develop medicines that improve lives. But our work only makes a difference if people can actually access those medicines.
When it comes to obesity care, we believe:
- Everyone should have open access to FDA-approved obesity treatments.
- Treatment decisions should be based on clinical evidence—not cost alone—and made by health care providers and their patients.
- Insurers, PBMs, and employers must work with us to find creative solutions and pricing models to expand access.
- Obesity medications should be covered just like treatments for any other chronic disease.
We’re committed to doing our part, but we can’t do it alone. We urge health care providers, policymakers, insurers, and others to come together to support evidence-based policies that make obesity care accessible to all who need it.
If recent coverage changes have affected your ability to access treatment, we offer resources to help you navigate your options in today’s evolving health care landscape.
About Lilly
Lilly is a medicine company turning science into healing to make life better for people around the world. We’ve been pioneering life-changing discoveries for nearly 150 years, and today our medicines help tens of millions of people across the globe. Harnessing the power of biotechnology, chemistry and genetic medicine, our scientists are urgently advancing new discoveries to solve some of the world’s most significant health challenges: redefining diabetes care; treating obesity and curtailing its most devastating long-term effects; advancing the fight against Alzheimer’s disease; providing solutions to some of the most debilitating immune system disorders; and transforming the most difficult-to-treat cancers into manageable diseases. With each step toward a healthier world, we’re motivated by one thing: making life better for millions more people. That includes delivering innovative clinical trials that reflect the diversity of our world and working to ensure our medicines are accessible and affordable.
