While the proliferation of effective antiobesity therapies has bolstered the diabetes management toolbox, familiar barriers to access dampen the benefit of these new drugs—sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists—to the overall population.

“We are in a moment where obesity and overweight are driving a lot of clinical decisions,” said Utibe Essien, MD, MPH, Assistant Professor of Medicine, David Geffen School of Medicine at the University of California, Los Angeles. “New antiobesity medications are being called game changers. Celebrities are talking about them every other day, so we’re almost in this revolution around these medications. We have a real opportunity to get ahead of what, sadly, we’ve been seeing with other medications where patients end up getting left behind.”

The panel discussion Ripple Effects after the Advent of Highly Effective Antiobesity Pharmacotherapy—Pharmacoequity in the United States will address the goal of ensuring that everyone has equal and affordable access to the highest quality medication to manage their health needs. The session will take place from 3:15 p.m. – 4:15 p.m. ET Monday, June 24, in Room W308 of the Orange County Convention Center.

“Unfortunately, obesity rates are increasing in our country, and that increases cardiometabolic diseases,” said Dr. Essien, who coined the term “pharmacoequity” in a 2021 paper. “Now that we are fortunate to have medication to help manage obesity, we unfortunately are going to see a story that’s played out regardless of the medication, regardless of the condition, which is that Black and Brown patients, regrettably, often get left behind when it comes to newer guideline-recommended, evidence-based therapy.”

Investigators have found that use of SGLT2 inhibitors and GLP-1 receptor agonists has been lower among Black, Asian, and Hispanic patients with diabetes. At the same time, among the Medicare population, the obesity rate is 60% for Blacks, about 50% for Hispanics, and 40% for whites, said ‌Alison Sexton Ward, PhD, Research Scientist, University of Southern California Leonard D. Schaeffer Center for Health Policy & Economics. She will discuss economic and public policy considerations in the U.S. that have the potential to reduce health disparities by expanding access to weight-loss drugs.

“The higher BMI categories such as BMI 35-39 and BMI ≥40 are where we see most separation between race and ethnic groups, which highlights that the current status quo for treating overweight and obesity isn’t solving these health disparities. In fact, it might be exacerbating them,” she said.

If an updated recommendation on weight loss and the prevention of comorbid conditions from the U.S. Preventative Services Task Force ranks the new weight-loss drugs high enough, Dr. Sexton Ward noted that private insurance would be mandated to cover these therapies through the Affordable Care Act.

“Policy decisions like providing widespread access to these drugs are a tool to shrink health disparities,” she said. “Those who have access to these new treatments—the wealthy in Hollywood and elsewhere who can afford to pay out of pocket for them or who have Cadillac insurance coverage already—are not the people who have the greatest need. So, we’ve looked at the value of treatment by race and ethnicity and also by education status, whether you have a college degree or not, and all of those things suggest that the greatest benefit from treatment is in those groups that are least likely to be able to afford to pay out of pocket for the new drugs, so if we expand coverage, there would be important impacts on health equity.”

Dr. Essien’s research has focused on how multiple factors, including income, education, employment, and social situations such as homelessness, affect access to treatment.

“All of those can have negative risks and lower access to treatment, but the sad reality is that even when we examine those factors in association with race and ethnicity, we still see that minoritized patients have the lowest access—even those who have high incomes, even those who live in urban settings, and even those who are well-employed,” he said.

Kristina H. Lewis, MD, MPH, SM, Associate Professor of Epidemiology and Prevention, Wake Forest University School of Medicine, will discuss what providers and patients are experiencing on the clinical frontlines in regard to access to antiobesity medication.

For those unable to attend the 84^th Scientific Sessions in person, this session will be available on-demand on the ADA virtual meeting platform following the meeting for registered participants.