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Diabetes task force explores ways to expand access to anti-obesity medications

MONTGOMERY, Ala. — A joint legislative task force charged with studying the impact of, as well as potential solutions to rising cases of  Type 2 diabetes in Alabama discussed the idea of expanding access to anti-obesity medications during its meeting on Tuesday.

Task force member Dr. Mary Hess argued that were certain drugs – particularly Semaglutide – made more accessible to Alabamians, the state could potentially save “millions, if not billions of dollars,” as well as prevent in additional 780,000 Alabamians from having diabetes.

In recent clinical trials, new anti-obesity medications have proven effective at helping patients lose significant amounts of weight, with obesity being the leading cause of diabetes. Alabama has a 38% obesity rate — the seventh-highest in the country — and could see drastically lower rates of diabetes were barriers to accessing certain medications lessened, or removed entirely, Hess said.

“Diabetes is not what I wish for any man in this state to have, so we must prevent this, and so we must decrease obesity,” she said. “Diabetes is challenging, diabetes is hard, and diabetes is escalating out of control.”

Samford University Professor Mary Hess.

Approximately 14.1% of Alabama’s more than 5 million residents – 550,149 – have been diagnosed with diabetes, Hess said, with an additional 119,000 having diabetes without having been diagnosed. More than 1.3 million Alabamians – 34.6% of the population – are prediabetic, with around 34,670 being diagnosed with diabetes every year.

A published author, Samford University professor and board member of Southeastern Diabetes Education Services, Hess also runs two health clinics – one in St. Clair County, and the other in Birmingham – where she routinely sees the effects of diabetes, as well as the lack of access to health care and medications.

“I wish that a lot of you could come and work with me in my two clinics and look at the patients that I care for that are in renal failure, blind, or do not have their lower extremities because diabetes has eaten them alive,” she said.

“I had a patient come in with a 14.8 A1C (blood test reading) and a blood glucose of 415, and they tell me that the reason their blood sugar was high is because they could not afford their medication. It is a real fact that in this state, our patients cannot get their medications.”

Simply having access to general health care, Hess said, was another potential factor in Alabama’s rising rates of diabetes.

“I had a young patient yesterday that had a below-the-knee amputation and he was blind in his left eye, and his A1C was 17.1,” she continued. “I asked him how long has it been since he’s seen a provider; he said he has no insurance and he did not have any money. I ask again, and he said it’s been four years.”

Developed by the Danish pharmaceutical company Novo Nordisk, Semaglutide is both an antidiabetic and anti-obesity medication approved for use in the United States in 2017. 

With years of patient data now available, studies, such as a 2022 study published in the National Library of Medicine, have found that weekly doses of the Semaglutide were “clinically effective for weight loss for people with obesity.” That same study saw the 175 participants see an average weight loss of 10.9% of their total body weight after six months.

Jeff Goforth, a medical account associate with Novo Nordisk, followed Hess with a presentation of his own, this time sharing with task force the findings of a five-year study on Semaglutide that instead focused on the drug’s effects on reducing cardiovascular risk factors. 

“These medications can save lives in patients who are overweight, have obesity and established cardiovascular disease,” Goforth said. “These medications should be therapeutic options for those folks.”

Ultimately, Goforth challenged the task force to identify barriers Alabamians have to access not just Semaglutide, but all anti-obesity treatments, and after doing so, to develop a plan to remove those barriers.

“Who has access to bariatric surgery, and who has access to the most effective medications for anti-obesity treatment, and if they don’t have access to things, why? What are the barriers, and how can we address those barriers? The residents of Alabama are at a disproportionate risk for these diseases, and they could use your help and support.”

Richard Embrey, a physician executive and member of the task force, suggested that with the existing health care system in the United States, expanding access to Semaglutide and other anti-obesity drugs may be a challenge.

“The larger problem is how we price medications in this country,” Embrey said. 

The task force, started by Rep. Ed Oliver, R-Dadeville, will either submit a report of its finding to the Speaker of the House next year, or vote to extend its meetings by another two years. Oliver told Alabama Daily News after the meeting that the immediate focus of the task force was to learn as much information as possible, and to “keep the conversation going.”

“Nobody doubts the effectiveness of the drugs that we’re talking about,” he said. “We are taking a holistic approach with this task force.”

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