Well the silver lining is that this will create a lot of good data from a large sample. Medicare won't cheat on methodology and analysis, no matter what the lobbyists want. This study could even end up being bad for GLP-1s.
Just hope it doesn't kill or hurt too many guinea pigs, er, people in the process.
And "just lift weights and eat more protein" is laughable, privileged and ignorant advice on the face of it. Seniors, even those without access problems, eat differently. As individuals, we eat differently as seniors than we did earlier. There are a number of variables involved and there's no "just" anything. And you aren't going to have 75 year old rushing to join gyms so they can lift weights. Again, many variables here.
Seniors are also notably (and I think appropriately) more resistant to all kinds of "shoulds." Once you can count your likely remaining years on your digits, a lot of things change.
But unfortunately, the diet culture "shoulds" so many of us grew up with are often quite resistant too, and I'm blown away by the number of senior therapy patients I have who are developing eating disorders for the first time. Some are freaked out by their midlife weight gain, and some are "inspired" by some kind of age-related weight loss.
well, you don't have to. But I'm a long time, doctoral level healthcare provider who has been involved in Healthcare policy for years. So I know how it works in academics, and I know how it works in politics, and I know how it works when you're just trying to get your claims paid.
At the political level, Medicare seems like a mess. But it's not. The basic problem with it is that it works well. I say this as a healthcare activist, as a Medicare provider and as a (regular form, not Advantage) Medicare consumer. And that's why conservatives hate it. The research is clean and the results are great. And nobody profits. And from all (inside) accounts, Dr. Oz is actually doing a good job. They certainly seem to be making some good common sense changes in some of the mid level policies. The providers - and companies - who are the unhappiest with them are the ones who think healthcare should be highly profitable. And those folks dominate the media.
So my confidence comes from years of experience and knowledge. If you want to find some hope in all of this, it's okay to trust me.
That’s so sad that seniors are developing eating disorders. Frailty and losing weights are huge risk factors for mortality and breaking bones as you age, which can also kill you.
What sticks out to me is that the duration of the bridge program is 78 weeks. This roughly tracks with the usual time frame I see on GLP-1 studies, which tends to be about 68-72 weeks. Assuming some weeks for promotion and uptake Medicare recipients would be taking these drugs for roughly that time period. This means that the bridge program is in the sweet spot for thr Medicare population on these drugs to show a downward trend in weight before it trends back up again. My guess is that the pharmaceutical companies intend to take this downward trend, correlate it with health improvements, and use it as a pitch for more coverage from private insurance.
Agreed. But I think they'll also keep track of side effects and people who quit, which is usually glossed over. Medicare won't want to pay millions for people to start a lifetime drug that doesn't work.
Well the silver lining is that this will create a lot of good data from a large sample. Medicare won't cheat on methodology and analysis, no matter what the lobbyists want. This study could even end up being bad for GLP-1s.
Just hope it doesn't kill or hurt too many guinea pigs, er, people in the process.
And "just lift weights and eat more protein" is laughable, privileged and ignorant advice on the face of it. Seniors, even those without access problems, eat differently. As individuals, we eat differently as seniors than we did earlier. There are a number of variables involved and there's no "just" anything. And you aren't going to have 75 year old rushing to join gyms so they can lift weights. Again, many variables here.
Seniors are also notably (and I think appropriately) more resistant to all kinds of "shoulds." Once you can count your likely remaining years on your digits, a lot of things change.
But unfortunately, the diet culture "shoulds" so many of us grew up with are often quite resistant too, and I'm blown away by the number of senior therapy patients I have who are developing eating disorders for the first time. Some are freaked out by their midlife weight gain, and some are "inspired" by some kind of age-related weight loss.
I wish I had a real voice in this.
Remember who is in charge of Medicare. I don’t share your confidence at all.
well, you don't have to. But I'm a long time, doctoral level healthcare provider who has been involved in Healthcare policy for years. So I know how it works in academics, and I know how it works in politics, and I know how it works when you're just trying to get your claims paid.
At the political level, Medicare seems like a mess. But it's not. The basic problem with it is that it works well. I say this as a healthcare activist, as a Medicare provider and as a (regular form, not Advantage) Medicare consumer. And that's why conservatives hate it. The research is clean and the results are great. And nobody profits. And from all (inside) accounts, Dr. Oz is actually doing a good job. They certainly seem to be making some good common sense changes in some of the mid level policies. The providers - and companies - who are the unhappiest with them are the ones who think healthcare should be highly profitable. And those folks dominate the media.
So my confidence comes from years of experience and knowledge. If you want to find some hope in all of this, it's okay to trust me.
That’s so sad that seniors are developing eating disorders. Frailty and losing weights are huge risk factors for mortality and breaking bones as you age, which can also kill you.
Agreed. And it's sad that so few HCPs don't know better than to promote this.
What sticks out to me is that the duration of the bridge program is 78 weeks. This roughly tracks with the usual time frame I see on GLP-1 studies, which tends to be about 68-72 weeks. Assuming some weeks for promotion and uptake Medicare recipients would be taking these drugs for roughly that time period. This means that the bridge program is in the sweet spot for thr Medicare population on these drugs to show a downward trend in weight before it trends back up again. My guess is that the pharmaceutical companies intend to take this downward trend, correlate it with health improvements, and use it as a pitch for more coverage from private insurance.
Agreed. But I think they'll also keep track of side effects and people who quit, which is usually glossed over. Medicare won't want to pay millions for people to start a lifetime drug that doesn't work.
Thank you for posting about this I was waiting for you to review this.
Also super excited about your new podcast!
I thought the whole deal that rfk had was NOT paying for glps under Medicare??? Can't even get that right. Smh 🙄