Excitement is building about a new generation of drugs that tout the ability to help adults with excess weight shed more pounds than older drugs on the market.<\/p>\n

Some patients, obesity medicine specialists say, are experiencing decreases in blood pressure, better-managed diabetes, less joint pain, and better sleep from these newfound treatments.<\/p>\n

The newer drugs, which are repurposed diabetes drugs, \u201care showing weight loss unlike any other medications we\u2019ve had in the past,\u201d said David Creel<\/a>, a psychologist and registered dietitian in the Bariatric & Metabolic Institute at the Cleveland Clinic.<\/p>\n

Yet for him and other experts, the thrill is tempered.<\/p>\n

That\u2019s because no single drug is a magic solution by itself, and it\u2019s possible many patients will need to take the drugs long term<\/a> to maintain results. On top of that, the newest treatments are often very costly and often not covered by insurance.<\/p>\n

The five-figure annual costs of the new medications are also raising concern about access for patients and what widespread use could mean for the nation\u2019s overall health care tab.<\/p>\n

Evaluating the trade-offs \u2014 weighing the value of better health and possibly fewer complications of obesity down the road against the upfront drug costs \u2014 will increasingly come into play as insurers, employers, government programs, and others who pay health care bills consider which treatments to cover.<\/p>\n

\u201cIf you pay too much for a drug, everyone\u2019s health insurance goes up. Then people drop off health insurance because they can\u2019t afford it,\u201d so providing the drug might cause more harm to the system than not, said Dr. David Rind<\/a>, chief medical officer for the Institute for Clinical and Economic Review, or ICER, a nonprofit group that reviews medical evidence to evaluate treatments for effectiveness and cost.<\/p>\n

Many commercial insurers currently limit coverage to only some of the drugs currently available, or require patients to meet certain thresholds for coverage \u2014 often pegging it to a controversial measure called \u201cbody mass index,\u201d a ratio of height to weight. Medicare specifically bars coverage for obesity medications or drugs for \u201canorexia, weight loss or weight gain,\u201d although it pays for bariatric surgery. Coverage in other government programs varies. Legislation that would allow medication coverage in Medicare \u2014 the Treat and Reduce Obesity Act<\/a> \u2014 has not made progress despite being reintroduced every congressional session since 2012.<\/p>\n

As insurers view the cost of treatments with concern, manufacturers see a potential financial bonanza. Morgan Stanley analysts<\/a> recently said \u201cobesity is the new hypertension\u201d and predicted industry revenue from U.S. obesity drug sales could rise from its current $1.6 billion to $31.5 billion by 2030.<\/p>\n

It\u2019s easy to see how they could predict that startling number based simply on potential demand. In the U.S., 42% of adults are considered obese, up from 33% a decade earlier. Health problems sometimes linked to weight, such as diabetes<\/a> and joint problems<\/a>, are also on the rise.<\/p>\n

Even losing 5% of body weight can provide health benefits, say experts. Some of the new drugs, which can help curb hunger, aid some patients in surpassing that marker.<\/p>\n

Wegovy<\/a>, which is a higher dose of the self-injectable diabetes drug Ozempic, helped patients lose an average of 15% of their body weight over 68 weeks during the clinical trial that led to its FDA approval last year. After stopping the drug, many patients followed in an extension of the trial gained back weight, which is not uncommon with almost any diet medication. Wegovy has spent much of the year in short supply<\/a> due to manufacturing issues. It can cost around $1,300 a month.<\/p>\n

Another injectable drug, still in final clinical trials but fast-tracked for approval<\/a> by the FDA, could spur even greater weight loss, in the 20% range, according to Eli Lilly, its manufacturer. Both drugs mimic a hormone called glucagon-like peptide 1, which can signal the brain in ways that make people feel fuller<\/a>.<\/p>\n