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CMS' semaglutide coverage expansion could save millions of lives

A group of 44 health care and advocacy organizations is urging the Centers for Medicare & Medicaid Services (CMS) to expand coverage and access to semaglutide for the treatment of obesity. Doing so, the group says, could mitigate the detrimental outcomes and comorbidities that often develop as a result of obesity, a disease that places significant burdens on individuals and the health care system.

"We recognise the critical link between obesity, cardiovascular disease and other comorbidities," said Dr Dharmesh Patel, MD, FACC, cardiologist in north Mississippi and president of the Partnership to Advance Cardiovascular Health. "By expanding coverage for semaglutide and other AOMs, CMS has an immense opportunity: In concert with lifestyle modifications, these medications can help many individuals avert CVD before it arises. We need to do more to support prevention when dealing with America's number one killer – heart disease. CMS can take a major step toward that goal by expanding coverage for semaglutide."

In a letter addressed to CMS Administrator Brooks-LaSure, the group commended CMS's decision to cover anti-obesity medications (AOM) for patients with existing, high-risk cardiovascular disease (CVD). The letter emphasized, however, the need to expand coverage of AOMs for primary use in treating obesity.

According to the Centers for Disease Control and Prevention (CDC), obesity significantly increases individuals' risk of developing CVD, which is responsible for almost 700,000 deaths annually, making it the nation's leading cause of death. This reality, the group asserts, underscores the necessity to deploy effective obesity treatments to prevent cardiovascular complications.

Recent research has demonstrated semaglutide's efficacy as an obesity treatment, having shown meaningful weight loss and improvements in metabolic parameters (like blood pressure, cholesterol levels and glycemic control) in patients.

Cosigning organizations across various disease states are hopeful that CMS will take proactive steps to expand coverage for semaglutide and other AOMs, preventing patients from developing life-threatening diseases.

To access the letter, please click here


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