Insurers clamping down on doctors who prescribe Ozempic for weight loss
The letters from the insurance company arrived in recent weeks, bearing a warning to health care providers who prescribe Ozempic, a diabetes drug that has gained popularity as a weight-loss treatment.
“The Special Investigations Unit has completed a comprehensive review of your prescription and professional claims,” said one letter to a Missouri doctor from insurer Anthem Blue Cross Blue Shield. Of the patients for whom the doctor prescribed Ozempic, the review found that more than 60 percent lacked “sufficient evidence” of diabetes, its Food and Drug Administration-approved use. The “education letter” warned that prescribing the drug for other conditions could put patients at risk, saying the insurer would refer “suspected inappropriate or fraudulent activity . . . to the state licensure board, federal and/or state law enforcement.”
Anthem used the same language in other letters, reviewed by The Washington Post, that went out to clinicians in New York and North Carolina, and their ominous tone signals a coming clash over new drugs that are upending treatment for obesity.
The drugs, often called GLPs, are fueling a frenzy among patients and a gold-rush within the pharmaceutical industry. Yet their high price tags, combined with the huge population that could benefit from them, presents a conundrum for insurance companies.
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