Oshman Lauren, Kirch Matthias, Solway Erica, Singer Dianne C, Malani Preeti N, Roberts J Scott, Kullgren Jeffrey T, Griauzde Dina Hafez
Department of Family Medicine, University of Michigan, Ann Arbor.
Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor.
JAMA Netw Open. 2025 Mar 3;8(3):e252008. doi: 10.1001/jamanetworkopen.2025.2008.
Medicare and many commercial insurers do not cover US Food and Drug Administration-approved weight management medications, such as incretin mimetics (semaglutide, tirzepatide, and liraglutide), bupropion-naltrexone, and phentermine-topiramate).
To assess older adults' interest in weight management medications and associated characteristics and to understand their perceptions about insurance coverage of weight management medications.
DESIGN, SETTING, AND PARTICIPANTS: This survey study used cross-sectional data from a nationally representative sample of US adults ages 50 to 80 years from the July 2023 National Poll on Healthy Aging. Data were analyzed from August to November 2023.
Outcomes of interest were estimates of interest in taking weight management medication and perceptions about coverage for US Food and Drug Administration-approved weight management medications by insurers, including Medicare.
Among 2657 respondents, 60.3% (95% CI, 56.7%-63.8%) were ages 50 to 64 years, 52.2% (95% CI, 49.8%-54.5%) were female, and 10.6% (95% CI, 9.3%-12.0%) were non-Hispanic Black, 11.4% (95% CI, 10.4%-12.6%) were Hispanic, and 70.3% (95% CI, 68.2%-72.4%) were non-Hispanic White. Overall, 35.1% (95% CI, 31.9%-38.4%) of participants were interested in using weight management medications, including 59.1% (95% CI, 53.4%-64.5%) of individuals with body mass index (BMI) of 30 or greater. Interest was most robustly associated with having used these medications in the past (adjusted odds ratio, 7.57 [95% CI, 4.41-13.02]) and BMI of 30 or greater (adjusted odds ratio, 5.04 [95% CI, 3.48-7.30]). Most participants (of any BMI) agreed that health insurance should cover weight management medications (2176 of 2625 respondents [83.2%]). When asked whether Medicare should cover such medications, most still favored coverage (2097 of 2616 respondents [75.7%]), but fewer approved of paying more for a Medicare premium to ensure coverage (829 of 2604 respondents [30.2%]).
In this survey study of older US adults, most participants agreed that Medicare should cover weight management medications and more than half of those with BMI of 30 or greater were interested in using them. These results should inform decisions to include weight management medications in the Medicare and commercial insurance programs, as well as utilization policies to control health care costs.
医疗保险和许多商业保险公司并不涵盖美国食品药品监督管理局批准的体重管理药物，如肠促胰岛素类似物（司美格鲁肽、替尔泊肽和利拉鲁肽）、安非他酮-纳曲酮以及苯丁胺-托吡酯）。
评估老年人对体重管理药物的兴趣及相关特征，并了解他们对体重管理药物保险覆盖范围的看法。
设计、设置和参与者：这项调查研究使用了2023年7月全国健康老龄化民意调查中50至80岁美国成年人全国代表性样本的横断面数据。数据于2023年8月至11月进行分析。
感兴趣的结局是服用体重管理药物的兴趣估计值，以及包括医疗保险在内的保险公司对美国食品药品监督管理局批准的体重管理药物覆盖范围的看法。
在2657名受访者中，60.3%（95%置信区间，56.7%-63.8%）年龄在50至64岁之间，52.2%（95%置信区间，49.8%-54.5%）为女性，10.6%（95%置信区间，9.3%-12.0%）为非西班牙裔黑人，11.4%（95%置信区间，10.4%-12.6%）为西班牙裔，70.3%（95%置信区间，68.2%-72.4%）为非西班牙裔白人。总体而言，35.1%（95%置信区间，31.9%-38.4%）的参与者有兴趣使用体重管理药物，包括59.1%（95%置信区间，53.4%-64.5%）体重指数（BMI）为30或更高的个体。兴趣与过去使用过这些药物（调整后的优势比，7.57[95%置信区间，4.41-13.02]）以及BMI为30或更高（调整后的优势比，5.04[95%置信区间，3.48-7.30]）最为密切相关。大多数参与者（任何BMI）都认为医疗保险应该涵盖体重管理药物（2625名受访者中有2176名[83.2%]）。当被问及医疗保险是否应该涵盖此类药物时，大多数人仍然赞成覆盖（2616名受访者中有2097名[75.7%]），但赞成支付更多医疗保险保费以确保覆盖的人较少（2604名受访者中有829名[30.2%]）。
在这项针对美国老年成年人的调查研究中，大多数参与者认为医疗保险应该涵盖体重管理药物，BMI为30或更高的参与者中有一半以上有兴趣使用这些药物。这些结果应为将体重管理药物纳入医疗保险和商业保险计划的决策以及控制医疗保健成本的使用政策提供参考。
