I practice in an area and with a population that has a lot of pediatric obesity. I've started to use GLP-1s on these adolescents. I'm talking about kids who weigh 350lb and are starting to get bony deformities from the weight. So recently, Medi-Cal changed their GLP-1 criteria so that they will only cover it for OSA, MAFLD/MASH/MAFLD/whatever we're calling it this week, and T2DM.
So now I have these kids who have hyperinsulinemia, acanthosis, etc. but they aren't diabetic (yet) and they don't have MAFLD (yet). I'm doing sleep studies on all of them, but at this point it's frustrating that the philosophy is that we're gonna wait UNTIL they get these conditions and THEN you'll cover it. The entire point of General Pediatrics is preventative care.
"So I need you to gain more weight so you get sicker and then you can have WEGOVY/MOUNJARO." /s
What's even more infuriating is that Eli-Lilly can absolutely provide tirzepatide for $450/mo. I know that because I pay for it out of pocket and that's what it costs. But they absolutely refuse to for patients going through their insurance. It's just all so morally and also fiscally corrupt.
Gaaaaargh.
-PGY-21