Increasing excess to weight loss injection shown to save thousands of lives a year

Abstract

The last 5 years have seen an explosion of research and development of novel and very effective anti-obesity therapy. These therapies have shown to produce up to 25% of weight loss as well as other health benefits among patients with cardio-metabolic diseases.

In a recently published study conducted by researchers at the Yale School of Public Health and the University of Florida, investigators have reported that expanding access to new, highly effective anti-obesity therapies could prevent more than 40 000 deaths a year in the United States.¹

To undertake the study, investigators utilized publicly available data to calculate mortality risk associated with different body mass index (BMI) categories and obesity prevalence. The annual mortality in the United States was recalculated by applying the BMI category-specific annual mortality rates to the new population distribution across various BMI categories resulting from the weight-loss associated with drug use. Using survey studies, prescription data, and cohort studies, current uptake rate of the drugs among eligible populations for obesity and for diabetes was calculated to be 10.8% and 10.7%–13.6%, respectively. The uptake rate was then recalculated based on the expanded assess scenario.

The study analysis showed that if access to these new medications were expanded to include all eligible individuals, 42 027 deaths could be avoided annually. This estimate includes approximately 11 769 deaths among individuals with type 2 diabetes. Even under current scenario of limited access due to costs and inadequate insurance coverage, the researchers project that around 8592 lives are saved each year, primarily among those with private insurance. Considering the geographic distribution of obesity and diabetes on a per capita basis, expanded access to weight-loss drugs among eligibles could lead to an annual mortality reduction of 9.6–15.7 deaths per 100 000 population. While all states could achieve a reduction of at least 9.6 deaths per 100 000 population, West Virginia, Mississippi, and Oklahoma are expected to experience the largest per capita reduction due to highest rates of obesity and type 2 diabetes in these states.

With the expanded access, 9977 deaths averted would be among Medicare beneficiaries and 2804 would be among uninsured. To account for the impact of socioeconomic factors on individuals' mortality risk beyond access to these drugs, investigators also adjust individuals' mortality reduction based on their income status. This leads to a conservative estimate of 32 906 fewer annual deaths. In contrast, as many as 165 574 annual deaths could be averted under the optimistic scenario of willingness and adherence. Increase access however needs to be balance with the caveat of stock supplies due to any limitations to the production of these therapies. Multifaceted public health approach will need to be implemented in order to successfully increase access to these very effective therapy for many patients.