Kęcka: Obesity Drugs Not Covered by Reimbursement as Lifestyle Changes Can Replace Them

During Wednesday's meeting of the parliamentary Health Committee, a representative of the Ministry of Health justified the lack of reimbursement for obesity drugs by citing current regulations. Deputy Minister Katarzyna Kęcka said that reimbursement cannot cover therapies that can be replaced by lifestyle changes. She explained that pharmacotherapy is only one element of treatment, which without parallel dietary, psychological, medical, and rehabilitation care will not bring lasting effects. In her opinion, such an approach would not constitute rational use of public funds. This stance was met with an immediate reaction from the medical community. Professor Mariusz Wyleżoł, a surgeon and bariatric specialist, responded that obesity is a biological disease, for which there is scientific evidence. His retort points to a significant conflict in the perception of obesity: as a lifestyle choice versus a recognized medical condition. According to data from the WHO, obesity is a serious health problem leading to diabetes, heart disease, and some cancers. The Ministry of Health simultaneously informed that work is underway on a regulation implementing the pilot program for comprehensive specialist care for patients with obesity, known as KOS-Bar. Services from this program are ultimately intended to be included in the guaranteed benefits basket. In the second half of last year, the ministry also received applications for the reimbursement of two specific active substances used in obesity therapy. However, according to the deputy minister, the administrative proceedings in this matter are only at an initial stage.In Poland, the obesity problem has been growing for years. According to 2023 research by the National Health Fund and the Central Statistical Office, over half of adult Poles are overweight or obese. In the healthcare system, obesity is formally recognized as a disease (code E66 in the International Classification of Diseases), but access to modern pharmacological treatment is limited and fully paid for by patients. The committee debate revealed a broader problem related to reimbursement in Poland. Key here is the interpretation of provisions regarding "replaceable therapy," which has become a subject of dispute between doctors and the public payer. Experts emphasize that while lifestyle change is the foundation of treatment, for many patients with advanced obesity it is not sufficient without pharmacological or surgical support. Critics of the ministry's stance point out that similar arguments about "replaceability" are not applied to drugs for hypertension or diabetes, where dietary modification and activity are also crucial.