An update to yesterday’s post about obesity and covering preventive services

Yesterday we discussed the positive step forward with payers being required to cover preventive services that are supported by “strong” clinical evidence.  However, we can lead a horse to water but not make them drink.  Without self-discipline and a willingness to take responsibility for our own health, such as losing weight, coverage of these services will not help significantly.  In addition, we all would rather pop a pill than change our lifestyle.

Unfortunately, it is likely to become more difficult to pop a pill to lose weight.  An FDA panel came out against a diet drug called Qnexa Thursday July 15.   The vote — 10 to 6 against Food and Drug Administration approval — dealt a blow to Vivus, maker of the medicine, and many overweight people looking for a new tool to help them shed pounds. It’s also an ominous sign for two other weight-management pills that are likely to be evaluated later this year.

What was the problem with Qnexa? Risks ranging from birth defects for babies conceived when women were taking the drug to an increased heart rate common among people taking Qnexa.

Even though people taking the highest doses of Qnexa had lost more than 10 percent of their weight a year after starting the medicine, the risks were too high, the federal panel concluded.

Qnexa is a combination of two old drugs: the epilepsy medicine topiramate and phentermine, the half of the fen-phen cocktail that didn’t cause heart problems.

The FDA is expected to make a decision on Qnexa by the end of October. The agency usually follows the advice of advisory panels, but not always.

For its part, Vivus said it will work with the FDA to address the questions raised during the hearing. In the next few months, the company expects to have additional safety data from longer-term study of the medicine. It’s unclear if that information will be enough to support approval of Qnexa.

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