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18 September 20234 minute read

Obesity coverage and Medicare: Q&A with George Hampton of Currax Pharmaceuticals

In this edition of Manifest, DLA Piper’s Jim Greenwood, Alex Pinson, Jamie Gregorian, and Kirsten Axelsen are joined by George Hampton, President and Chief Executive Officer of Currax Pharmaceuticals, to talk about the evolving landscape of obesity treatment: the challenges facing the healthcare system, the need for more classes of pharmacotherapies to answer patients’ complex needs, and the role of Medicare.

Q: George, thank you for joining us. Tell us a bit about Currax Pharmaceuticals and your focus as a company.

A: Currax is a privately held patient-first pharmaceutical company focused on the number one and number two causes of preventable deaths in the United States: smoking addiction and obesity. We produce a variety of pharmaceuticals, both branded and generic, approved to treat obesity, migraines, insomnia, and other diseases.

Q: Obesity medications have often been in the news this year, largely focusing on the lack of Medicare coverage for these drugs, but obesity is not a new challenge in the United States. How has the obesity crisis and market for weight management medications evolved over your career in the pharmaceutical industry? What effect has that had on patient access?

A: For years, obesity was unfortunately viewed as a lifestyle choice, which stymied innovation and patient access to treatment. That changed when the American Medical Association first recognized obesity as a disease in 2013. Since then, the industry has responded to the challenge by developing multiple new classes of medications, but regrettably only two to three percent of Americans with obesity are being treated with pharmacotherapy. Although the percentage of those on treatment seems to be growing, this low number of patients on therapy is primarily due to the lack of reimbursed coverage for Medicare and commercial patients alike. In the meantime, the prevalence and severity of obesity has increased, and diseases associated with obesity, such as heart disease, stroke, type 2 diabetes, and certain types of cancer, continue to cause unnecessary, preventable deaths. This in turn is costing the US healthcare system $11 billion, or more, in additional expenditures each year.

Q: Is this consistent with how the American healthcare system has historically controlled chronic diseases?

A: Certainly not. Our society has achieved great success in controlling many chronic diseases through intervening with medications, devices, and services early in the patient’s disease journey. In the case of obesity, we’ve ignored the disease and failed to intervene, and, consequently, obesity is now our nation’s number one epidemic. Well controlled chronic diseases require distinct therapeutic classes of medications based on the needs of each patient. Armed with the diagnosis and patient profile or phenotype, physicians then determine which class (or combination of classes) is most appropriate. Hypertension and type 2 diabetes are good examples of chronic diseases with mature therapeutic markets. Between the two, there are eleven different classes of medications with over fifty approved drugs available today. When there are multiple drugs, physicians have more options to treat each patient’s specific phenotype, and insurance companies negotiate price discounts for placing specific drugs in preferred positions on formulary, which is intended to lower the out-of-pocket costs for the insured patient.

Q: How many classes of FDA-approved medications are indicated for obesity and how do they work?

A: There are three classes of approved products, and thankfully more are on the horizon. Amphetamines, which are DEA controlled substances administered orally, speed up a patient’s metabolism to burn calories faster. Currax’s Contrave is an orally administered fixed-dose combination of naltrexone and bupropion that targets both the hunger and reward systems in the brain. Glucagon-like peptide-1 medications, known as GLP-1s, are injectable medications that mimic a hormone to make a patient feel full. We expect to see GLP-1 combination therapies in the near future, which would represent a fourth class of obesity medication.

Q: Are there any proposals to fix the Medicare reimbursement gap?

A: Yes. In 2023, for the sixth time, Congress introduced the Treat and Reduce Obesity Act (TROA), which would require expanded coverage of new healthcare specialists, regular obesity screenings, and obesity medications for Medicare recipients. By covering obesity medications as proposed in TROA, Medicare could save between $175 billion and $245 billion over ten years and motivate commercial payors to institute obesity medication coverage. We are encouraged by the innovation in obesity care, and I’m grateful for DLA Piper’s help as Congress works to make this bipartisan legislation a reality.

Q: Any final thoughts?

A: Improving outcomes for patients with obesity is achievable and affordable – now. Obesity is a complex and chronic disease; our society has a proven history of treating and controlling chronic diseases. We have the necessary classes of medications and services to affordably slow the progression of the disease and change the trajectory of this epidemic. Patients battling obesity deserve the same benefit of reimbursed access to medications as patients with other chronic diseases.