What We’re Reading: Weight Loss Drug Adherence; Free Birth Control Access; Organ Transplant Test Access

Wegovy Adherence Far Higher Than With Older Weight Loss Drugs

An analysis of medical records and insurance claims data showed that 40% of patients who filled a prescription for semaglutide (Wegovy) to treat obesity in 2021 or 2022 were still taking it a year later, according to Reuters. This adherence rate was more than 3 times that of older weight loss drugs. For example, only 13% of patients taking naltrexone/bupropion (Contrave) and only 10% of those who started phentermine/topiramate (Qsymia) between 2015 and 2022 were still filling their prescriptions a year later. The researchers also found persistence at 1 year to be associated with greater weight loss at 6 months. Conversely, they found adherence rates within privately insured patients varied by insurance carrier due to coverage limitations and certain pre-certification criteria, like step therapy. Consequently, concerns have been raised over the high costs and non-persistence associated with weight loss drugs as this could inform third-party payers' coverage decisions.

Democrats Urge Biden to Secure Broader Free Birth Control Access

Both Democrats and reproductive rights organizations are reinforcing their pressure on the Biden administration to ensure health insurers fully cover contraception, according to Axios. Under the Affordable Care Act (ACA), most insurers are required to cover at least 1 form of each FDA-approved contraception method at no cost. Groups are claiming that companies are failing to meet the ACA requirement, with evidence that some insurers are improperly charging women or denying coverage of some birth control methods. More specifically, last month, members of Vermont’s Democratic congressional delegation called on the Biden administration to enforce mandated birth control coverage, as a state investigation found that over 9000 patients were wrongly charged for contraceptive costs. Vermont was not the first state to report insurance denials, causing the Biden administration to remind insurers of their coverage obligations last year and look at new ways of expanding birth control access.

CMS Change Impacts Patient Access to Lifesaving Organ Transplant Tests

CMS implemented changes to Medicare in March that limited access to blood tests that help transplant recipients ensure their organs remain healthy, according to USA Today. CMS said in a statement that Medicare administrative contractors discovered improper billing and overuse of the tests. As a result, CMS updated billing and coding to limit who can administer the tests for the MolDX molecular testing program and where. Medical experts and patient advocates explained that the Medicare change limited patient access, putting them at immediate risk, particularly those who are low-income or people of color who already face existing barriers to care. On Tuesday, a bipartisan group of lawmakers planned to call on the Biden administration to reverse the change, especially due to the recent law streamlining a waitlist of more than 100,000 people waiting for organ transplants. These patients will all need testing to ensure their organs remain healthy, and experts and advocates fear a lack of adequate testing will lead to more failed organs.