Yes, I understand.

I think maybe I poorly worded that, let me try it another way.

If we're going to say Z91.1 is a reason to justify pharmaceutical treatment at the expense of the healthcare system wouldn't it make more sense to allow those dollars to be spent on the compliant patients?

We're increasing the dollars spent on patients who don't want to what their primary care physician instructs them to do. Want to take ozempic and you're non compliant, okay...pay for it. Want to take ozempic and you're compliant, why do you need ozempic? Do the meds need asdjusting? Is your A1c in range? Are you on a statin?

The default here to increase spending on the non compliant is madness and is costing billions of dollars a year with no long term improvements because the issue isn't diabetes or weight loss, it's wasting too much money and resources on the non compliant who have zero desire to be compliant or accept the financial burdens of their non compliance.

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Posted by Uncle JackD

Member since Nov 2007

58680 posts

Posted on 3/8/24 at 1:24 pm to LSUfan4444

quote:
If we're going to say Z91.1 is a reason to justify pharmaceutical treatment at the expense of the healthcare system wouldn't it make more sense to allow those dollars to be spent on the compliant patients?

You do realize the majority of healthcare would fall under this non compliance coding, right? I work in nephrology, 95 % of our patient load would not qualify for medical care under your terms. It’s just not feasible. Hell, 9/10 people would get turned away from the ER under those terms.

The system is frickED, there’s no denying that. But why is it okay for person 1, the non compliant diabetic with a BP of 190/110, to get the care he needs at no additional cost but person 2 shouldn’t get his ozempic filled because that is going to break the system… nahh those GLPs are a drop in the bucket compared to the millions wasted in healthcare on a daily basis.

Maybe some people will get the GLPs and still eat and drink like shite. But I’d be willing to bet over half will change their habits completely and hopefully avoid the predicament person 1 is in above. I believe some plans are already requiring a minimum % of weight loss during certain time frames while on the med, which is fine IMO.

quote:
wasting too much money and resources on the non compliant who have zero desire to be compliant or accept the financial burdens of their non compliance.

Again, this is happening every single minute of the day already. It’s happening in front of my eyes as I type this. It’s not something we can stop but maybe GLPs can slow it down. It’s definitely worth a shot because the current path isn’t sustainable.

This post was edited on 3/8/24 at 1:30 pm

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