When you speak with people affected by obesity, it is impossible not to feel the deep sense of helplessness this disease can inflict. It is impossible not to sympathize and understand that so many people feel they have exhausted all options in their journey toward experiencing the positive health outcomes that others have the opportunity to experience every day.
“It would mean the difference between being able to keep up with my children and not being able to do anything with them,” said a recent Obesity Matters survey respondent on the topic of the need for public reimbursement of obesity treatment Wegovy™
“It would mean I could live life instead of watch it pass by,” said another Obesity Matters community member.
Obesity Matters conducted a survey from March 2 to 15, 2022, asking community members what it would mean to achieve sustained weight loss of at least 5 per cent, and up to an average of 15 per cent. The response was overwhelming.
Weight loss of 5 – 10% is clinically significant, meaning people who lose this percentage of weight are expected to have health benefits. That range of 5 per cent up to an average of 15 per cent weight loss was demonstrated in clinical trials of Wegovy™, an injectable prescription medicine for adults living with obesity and the first and only weight-loss medication with weekly dosing.
Used with a reduced calorie diet and increased physical activity, Wegovy can help people lose weight in a sustainable way and truly make a difference in the lives of people managing overweight and obesity.
The problem is, many Canadians may not be able to access Wegovy, or other available obesity treatments, because of the cost of paying out of pocket.
Wegovy is currently under review by Canada’s Drug and Health Technology Agency (CADTH) which will soon decide whether to recommend Wegovy for subsidization by provincial drug programs.
When Obesity Matters surveyed our community to get feedback on the matter, the message was clear: Canadians living with obesity and overweight need evidence-based support, and CADTH should acknowledge that obesity is a disease and be part of the health care outcomes solution in Canada to ensure patients are served by provincial drug programs by recommending that Wegovy be reimbursed.
Failure to recommend reimbursement would show that Canada does not see, hear and recognize obesity as a disease, and Wegovy as offering clinically significant and socially impactful weight loss of at least 5 per cent to appropriate patients.
Wegovy can provide healthy weight management to help patients who are seeking support and have been denied equitable access to health care on public health plans in Canada to-date.
The evidence of need is clear with roughly 63 per cent of Canadians living with increased health risks due to excess weight and no treatments indicated for overweight or obesity currently recommended for reimbursement on regional drug plans. About 27 per cent of Canadians are classified as living with obesity, and we know the problems this disease presents to many segments of society.
We also know that obesity increases with age, calling into question why CADTH and the regional drug plans have yet to provide evidence-based obesity treatment options to the older impacted demographic that governments are mandated to help protect from a health and safety perspective.
From a health perspective, the consequences of obesity are well recognized and include increases in blood pressure, fatty liver disease, the onset of type 2 diabetes, sleep apnea, asthma, osteoarthritis, infertility, at least 13 different cancers and is associated with more than 200 other possible health complications.
With so many severe societal ramifications, does it not make sense to do everything in our power to break this circuit at its source? Medication for diabetes, hypertension and many other obesity-related conditions are already either subsidized or covered by provincial health care plans. Funding treatments that address the co-morbidities of obesity while not funding obesity treatments is illogical, non-evidence-based, fiscally irresponsible and adds further burden to patients managing obesity.
Bariatric surgery and other surgical options to address healthy weight are also covered in Canada, further calling into question why evidence-based pharmacological treatments funded by regional drug plans have not yet been made available to doctors and patients in Canada.
The CADTH and Canadian government are woefully behind in this area compared to other countries as the lack of affordable treatment options compared to the number of people living with the disease has left a massive gap in treatment. Sticking with the status quo is not acceptable and further perpetuates the inequity of access to care for this patient population.
Reimbursement of obesity medications are rising across the globe with eight of the 15 countries with restricted reimbursement for obesity treatment Saxenda coming in the last two years. Columbia, Israel and the United Kingdom in particular have progressed toward reimbursement of Saxenda.
Wegovy is not far behind and is well on its way to public reimbursements in the UK. In fact, the National Institute for Health and Care Excellence (NICE) in the UK recently completed their HTA review of Wegovy and issued draft guidance recommending it. And yet, Canada is a laggard in its understanding of obesity and failure to reimburse evidence-based treatments.
88.46 per cent of Obesity Matters’ survey respondents listed drug costs as the number one barrier to their ability to manage a healthy weight. Drug costs were a bigger barrier for respondents than the cost of healthy food, the cost of exercise or trainers, the costs of dietitians, lack of healthcare practitioner support or even weight stigma.
Contrary to stereotypes and stigma related to people managing overweight and obesity, this patient population is not composed of people who are looking for a quick fix for aesthetic reasons – we know there are no quick fixes when it comes to managing a healthy weight and obesity.
48 per cent of our survey respondents have already taken other prescription medication for obesity and are seeking evidence-based support for health purposes: these are people with real health problems, both mental and physical, who need help.
These are people who want to live longer, healthier lives, reducing the chances of obesity-related comorbidities and complications.
These are people who want to participate in society, watch their children and grandchildren grow up and be able to function normally without stigma or pain.
“I want my life back. Obesity has robbed me of this. I am not a lazy slob sitting on my butt eating crap. I do not deserve to have obesity,” wrote one survey respondent. “Canada has a publicly funded healthcare system … and yet good health in Canada is treated as a privilege instead of a right for those with obesity.”
89 per cent of Obesity Matters’ survey respondents said they have had to change social or recreational plans due to managing obesity. 97 per cent said obesity has impacted their health, and 97 per cent have tried restrictive diets, exercise programs, obesity treatments, diet supplements or some other weight management solution and are still searching for a solution.
Treating obesity properly with evidence-based approaches outlined in the Canadian Obesity Guidelines, where pharmacotherapies are referenced as a first line treatment pillar, can have a significant positive impact on the quality of a patient’s life, and surely the clinical benefit and safety profile justify public payers reimbursing the product as a medically necessary treatment.
Losing weight for people living with obesity is not a simple matter of willpower because obesity is not a choice. Obesity is a chronic disease and is finally being treated as such more and more by the global medical community including the Centre for Disease Control (CDC).
With no Health Canada approved treatments covered by government drug programs in Canada, the current policies continue to perpetuate weight stigma and discrimination for people managing overweight and obesity in Canada.
Will the CADTH and Canadian government step up and join the rest of the world in recognizing obesity as a chronic disease and allow people to access proper health care? Or will they force millions to sit on the sideline?
Obesity Matters is clear on its message and advocacy for equal access to evidence-based treatments. If you want to help us on this journey to help people get the care they deserve while ending stigma against those living with this chronic disease, follow obesitymatters2us on social media or visit obesity-matters.com and help us make an impact. Obesity Matters has cultivated a passionate community whose feelings can be summed up by this survey respondent:
“I fight every day for my health. I need more support,” they shared. “Every moment of my life is dedicated to getting better, I can’t give more than that, stop the bias and give us the safety nets/options we deserve as humans. The Obesity epidemic is most definitely a result of government choices, it’s time to clean up this mess or pay a huge healthcare price in the future.”