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Arena Pharmaceuticals, Inc. (ARNA), VIVUS, Inc. (VVUS): Payday on the Way for America’s New Epidemic Disease?

Published on July 1, 2013 at 8:57 am by The Motley Fool in News
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That could be, but bigger insurance reimbursement checks aren’t in the mail yet.

CIGNA Corporation (NYSE:CI)‘s senior medical director for coverage policy, Julie Kressel, said the company doesn’t anticipate any major changes. She noted that CIGNA Corporation (NYSE:CI) already pays for obesity treatments in many cases. The company hasn’t classified obesity as a disease in the past but views it as a chronic medical condition.

Aetna Inc (NYSE:AET), the nation’s third-largest health insurer, already covers use of weight-loss drugs, such as Belviq and Qsymia, in some instances. Patients must have first unsuccessfully tried to lose weight with a six-month regimen including diet, exercise, and behavioral therapy. Any of these patients who failed to lose at least one pound per week and have a body mass index, or BMI, of 30 or higher can receive reimbursement for weight-loss drugs. These drugs are also covered for any of the patients with a lower BMI of 27 or higher who have one of several obesity-related conditions.

However, the biggest health insurer, UnitedHealth Group Inc. (NYSE:UNH), doesn’t cover obesity drugs as of yet. The company provides reimbursement for bariatric surgery in some cases but excludes coverage for prescription drugs or any other weight-loss medications.

Although covering more obesity treatments such as weight-loss drugs could cause insurers to feel a financial pinch at first, the companies could actually save money over the longer horizon. Mike Thompson, a principal with PwC’s global human resources practice, said that over time insurers could see a positive impact as a result of lower overall health-care costs associated with reducing obesity.

Payday someday
Not everyone agrees with the AMA’s decision to use the word “disease” in describing obesity. The group’s own Council on Science and Public Health even stated that labeling obesity as a disease could “improve health outcomes for some individuals, but may worsen outcomes for others.”

Concerns have also been raised about the use of BMI as the benchmark for determining who is obese and who isn’t. Atlantic health correspondent Dr. Richard Gunderman notes that athletes often have high BMIs but are in great shape. Gunderman observed that even Dwayne “The Rock” Johnson would be considered obese on the AMA’s BMI scale.

Despite the AMA’s recent decision, the matter isn’t yet settled. More money could be on the way for companies offering obesity treatments, especially if the federal government enacts new laws. A payday is likely someday — but that “someday” is still in the future for now.

The article Payday on the Way for America’s New Epidemic Disease? originally appeared on Fool.com is written by Keith Speights.

Fool contributor Keith Speights has no position in any stocks mentioned. The Motley Fool recommends UnitedHealth Group.

Copyright © 1995 – 2013 The Motley Fool, LLC. All rights reserved. The Motley Fool has a disclosure policy.

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