Sunday House Call, #909, January 14, 2024: How health insurance company wanna-be-doctor bean counter’s medication-coverage decisions interfere with therapeutic management and has had a deleterious effect on (my) patients’ health outcomes.

I talked about this before yet this continues to be a major issue in that evidence-based medicine is being thwarted by insurance companies’ decision to not provide Semaglutide (Ozempic) for the treatment and management of obesity. It is having a deleterious effect both from a mental and physical health perspective on my patients.

Wasn’t the goal to prevent illness in the first place? Would it not provide a win-win situation in that prevention of significant diseases such as heart disease, diabetes, stroke, kidney disease, osteoarthritis, fatty liver disease, among others would, over time, reduce costs to care for these conditions?

Apparently, the insurance company knows better.

Your Calls and Comments:

  • Oral thrush
  • Treatment and management of basal cell carcinoma
  • Caller recounts a history of his physician not listening to his concerns about a nonhealing sore on his forehead. Patient has type II skin with freckling. Eventually found to have basal cell carcinoma after 2 years of delay.
  • Ozempic availability
  • Can seniors in Ontario be prescribed Ozempic?
  • Does Ozempic come in pill form?
  • Can Ozempic be used for someone who has atrial fibrillation?
  • Management of large abdominal hernia
  • Man reports A1c is 6.2%. He is 66 years old and weighs 185 pounds. Height is 5 foot 8. He wants to know if he is prediabetic.
  • 73-year-old woman has gained a lot of weight. Her diet is very light but she continues to gain weight. Her doctor has recommended Ozempic to help her. She wants no but any studies about long-term effects. Discussed long-term effects from increasing weight versus the use of the medication to prevent this.