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10/24/2021 04:12 PM
Pennsylvania State Senate
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=S&SPick=20210&cosponId=35306
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Senate of Pennsylvania
Session of 2021 - 2022 Regular Session

MEMORANDUM

Posted: April 6, 2021 03:49 PM
From: Senator Joe Pittman
To: All Senate members
Subject: Payment for FDA Approved Anti-Obesity Drugs
 
In the near future, I plan to introduce companion legislation to HB 293, prime sponsored by Representative Donna Oberlander. This proposed legislation will allow U.S. Food and Drug Administration-approved (FDA) anti-obesity drugs to be considered a compensable service under our State Medicaid Program.
 
In 2013, the American Medical Association (AMA) officially classified obesity as a serious and chronic metabolic disease. Obesity in rare cases may have a single cause, but it usually is a combination of several biological, behavioral, environmental, and genetic factors. According to the 2019 Behavioral Risk Factor Surveillance Survey, 33 percent of Pennsylvania adults are affected by obesity. As such, it is critical for the health of Pennsylvanians that we recognize this disease and provide access to the same medical therapies as we do other diseases.
 
According to guidelines published by the American Association of Clinical Endocrinologists and the American College of Endocrinology as well as the American Heart Association, American College of Cardiology, and The Obesity Society, there are three evidence-based options for treating obesity. These include lifestyle-based treatments, prescription weight-loss medication, and bariatric surgery. The Department of Human Services currently covers a comprehensive scope of behavioral health services as well as bariatric surgery for persons with extreme or severe obesity when medically necessary. As such, any drug prescribed to curtail obesity is considered a non-compensable service under the State Medicaid Program. Over the past few years, new medications have been approved by the FDA for chronic weight management. These drugs have been approved for adults that meet specific criteria, including co-morbidity with one or more other medical conditions (e.g. high blood pressure, diabetes, high disease, and sleep apnea).
 
While not every patient who benefits from the State Medicaid Program will be approved for the use of such medications, nor will those medications be successful for every patient, it is imperative that State Medicaid patients have access to them, just as they have access to medications that treat other diseases. There is no single or simple solution to treating obesity, so it is important to recognize it as a complex problem that requires a different approach based on the needs of the patient.
 
I hope you will consider co-sponsoring this important piece of legislation. If you have any questions please feel free to contact Sarah Stauffer, of my staff, at sstauffer@pasen.gov or 717-783-5193.



Introduced as SB782