Obesity Drug Access Is About To Expand Via Medicare
For many seniors, the weight is almost over: Starting on Wednesday, Medicare will begin covering obesity drugs for the first time, allowing millions of Americans to obtain popular medications like Wegovy, Zepbound, or Foundayo for a $50 monthly co-pay.
What’s changing? Medicare already covers GLP-1 drugs for the treatment of some health conditions, like cardiovascular disease and Type 2 diabetes, but the new rules apply specifically to weight loss treatments. To be eligible, participants need to be enrolled in the Medicare Part D drug plan and meet certain weight and health requirements.
The program is currently slated to run through 2027, though there are talks to extend it.
Why haven’t I heard about this? Drugmakers have done everything but hire a town crier to advertise weight loss drugs, but there hasn’t been as much buzz about the Medicare change. That’s in part to allow for a kind of soft launch that lets physicians and pharmacies work out the kinks. The Centers for Medicare and Medicaid Services (CMS) has also said it doesn’t want to go the Grand Theft Auto VI route and get everybody hyped about something that’s not available yet.
But make no mistake, drugmakers are jockeying for position, because even though their drugs are being discounted, they expect to make up the difference through volume. According to the federal government, more than 56 million Americans have Medicare Part D, and about 38% of seniors have obesity.—BC
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