Oprah Winfrey to Chelsea Handler – Skinny Shot Popularity Clouds Healthcare Underwriting
The Semaglutide Craze
Weight loss is trending in the realm of healthcare. Over the past few years, there has been a significant increase in the amount of people that are using an injection containing Semaglutides to lose weight.
These shots were originally created to assist with lowering A1C in pre-diabetic or Type 2 diabetic patients. A1C is the measure of the percentage of your red blood cells that have sugar-coated hemoglobin. The higher the A1C score the higher the risk of becoming a diabetic.
It was discovered that the use of these drugs had a weight loss component. This discovery has created “off-label” use as a weight loss drug.
This “skinny shot” craze has created a multitude of problems for patients who need the medication for treatment of type 2 Diabetes.
Some healthcare companies are scrutinizing the use of the medicine to make sure the patient has a real need and are not using it strictly for weight loss. Should the insurance companies decline to provide coverage, this medication sells for a high premium. Depending on the drug, the price can range from $895 to $1300 for a one-month supply.
Another concern is the shortage of this medication. The substantial number of new prescriptions has created a shortage for diabetic patients. Some shipments have been back ordered for as long as three months.
There are alternative medications available that have been approved for weight loss. Most healthcare carriers will not provide coverage for these alternatives, and this has driven healthcare providers to use the drug that has been approved for diabetes but not weight loss. Word of mouth is driving this craze and it is speculated that there have been parties to obtain the medication.
One of the most concerning factors are the side effects that long term use of Semaglutides for weight loss can cause.
The side effects range in severity, with the most concerning side effects below:
- Possible thyroid tumor, including Cancer
- Inflammation of pancreas (Pancreatitis)
- Gallbladder problems
- Increase risk of low blood sugar in patients with type 2 Diabetes
- Kidney problems and possible kidney failure
- Allergic reactions
- Increased heart rate
- Depression or thoughts of suicide
The health risks are not the only problem that excessive use of Semaglutides based medications has created.
The excessive over prescribing of these drugs has created a challenge for insurance carriers properly underwriting facilities like medical spas and weight loss clinics. Most of the professional liability policies have an exclusion which excludes coverage for the use of non-U.S. Food and Drug Administration approved medications.
Many of these facilities are prescribing medication for “off-label” use. If a drug has not been approved to use for weight loss and the provider is prescribing it, the insurance carrier can decline a claim for injury caused by using the medication.
Due to the expense and shortage of the medication, some facilities have found a way to have Semaglutide created by going to compounding pharmacies. The cost is around $400 a month.
This creates another issue for insurance carriers trying to properly provide coverage for these facilities. Several insurance carriers have confirmed that they will not provide coverage for a compounded form of Semaglutide as they cannot be sure that the medication has the same ingredients as the FDA approved version. Another large concern is that the mixture could contain sodium and it could be a danger for patients with blood pressure issues.
Some insurance carriers will offer a carve back for the compounding of the Semaglutide. It’s always good to double-check to see if the facility uses a compound form of the medication.
There is speculation that this craze will continue despite the unknown long-term side effects.
About the Author
Charlotte Finver is a wholesale insurance Broker with Founders Professional. She focuses on assisting retail insurance agents in the placement of their hard-to-place healthcare, life sciences, management liability, and cyber liability insurance risks. Charlotte can be reached directly at [email protected].