The United States of America has the 13th highest obesity rate in the world, according to the World Obesity Federation globe observatory. The Centers for Disease Control and Prevention report that more than 1 in 5 adults and 1 in 5 children live with obesity. For decades or longer, American society has blamed the individual themselves for their weight, declaring them to be lazy or, gluttons, or worse. Thankfully, modern science has begun to break through that unwarranted social stigma with the understanding that obesity is a chronic disease and that medical intervention, not simply self-control and fad diets, is the true solution to this overwhelming problem. Unfortunately, access to these medicines for seniors is limited by an outdated law, that could only be changed by Congress taking sensible action.
I was the longest serving Republican Staff Director on the United States Senate Health, Education, Labor and Pensions (HELP) Committee. I held that position for a decade and helped pass laws that support medical innovation like the 21st Century Cures Act, I know the power of that committee. So I’m saddened to see its time being wasted on a senseless investigation of the obesity drugs, rather than on making meaningful change to make them available to people with obesity in the U.S.
After decades of research and billions in investments, science has found solutions in the form of the newest wave of innovative anti-obesity drugs that, for many patients, provide remarkable success in weight loss and health improvement. As these drugs finally come to market, it is, unfortunately, no surprise that there is much performative gnashing of teeth over the fact that the researchers and investors in those long-sought solutions want to see a return on their investment. It is a shame that innovators are facing demagoguery and disingenuous interrogations by people who have the tools at hand to understand the dynamics of the healthcare system. Instead of determining how to provide affordable access to the greatest number of people in need, members of Congress are creating another drug pricing spectacle.
The Senate HELP Committee, usually a bastion of bipartisan cooperation and sensible policy-making, has current leadership that seems outraged that drug makers are seeking to make a profit. There seems to be no recognition of the need to recoup decades worth of research and development costs, investments in personnel and laboratories, and controversial decisions to keep going when the science was unclear. Failed experiments don’t have a return on investment, but without those failed experiments, researchers wouldn’t learn what to study next. Without the promise of learning from mistakes, investors won’t invest in the next round of research.
Instead of attacking the innovators, assaulting the investors, and demeaning the risk-takers, with hearings and inquires about drug prices a government that wants to address a problem should use the resources it has at hand to help people with obesity who want to get treated have affordable access to effective medicines. This happens with insurance coverage. This allows the health plans to do the work they are far better suited to than Congress, beating up the drug companies for discounts to lower the costs of medicine.
Start with Medicare. Medicare doesn’t currently cover anti-obesity medication for most enrollees. Certainly, that would be expensive in the short term, and Congress would need to figure out how to pay for it, but governing is about making choices and doing hard things. Additionally, within a short period of time under the Inflation Reduction Act, anti-obesity drugs would likely quickly move up to the top of the line for price negotiation when they are eligible. In the meantime, the insurance companies offering Part D plans would be able to demand discounts for formulary placement.
Instead of lamenting the research and development model that brings more treatments and cures to market faster and better than ever before, Congress could demonstrate the math behind the Federal government's decision to cover obesity in its health plan, the Federal Employee Health Benefits program, and show state, local, and private health insurers the cost and benefits of covering these life-altering drugs.
Legislating is supposed to be hard work. Coming up with an idea, negotiating a bipartisan solution, figuring out how to pay for it, and passing legislation takes time and patience, but the American people expect the Senate to do that. The Senate should get to work on lasting legislative solutions that meaningfully improve health and reduce the burden of chronic disease, not cheap demagoguery and short-term stunts. The American people deserve better.
David Cleary is now a Senior Policy Advisor at DLA Piper, working with clients in industries including life sciences.
