Topline
Medicare will soon cover the weight loss drug Wegovy for its members who have heart disease and an increased risk of heart attack and other cardiovascular issues. This is a significant departure from the agency’s previous stance of not providing coverage for weight loss drugs.
Wegovy is manufactured by Novo Nordisk. (Photo by: Michael Siluk/UCG/Universal Images Group via … [+]
Key Facts
Medicare has issued guidance allowing Medicare Part D plans to cover weight loss drugs as long as they treat diabetes or reduce cardiovascular risks in adults with heart disease, obesity, or overweight conditions.
Wegovy, an injectable weight loss drug designed for adults with cardiovascular risks and obesity, falls within the new guidance and is now eligible for coverage under Medicare Part D.
The drug will not be covered for Medicare members seeking to solely use it for weight loss purposes.
Wegovy’s approval under Medicare could result in thousands of prescriptions for adults and a significant increase in healthcare spending.
As of March last year, approximately 51.5 million people were enrolled in Medicare Part D, according to government data.
Big Number
Around $1,200 is the approximate list price of Wegovy, a once-weekly injectable weight loss drug for adults with cardiovascular risks and obesity.
Key Background
Wegovy recently received approval from the Food and Drug Administration (FDA) as the first weight loss drug that also helps prevent cardiovascular problems. This approval came after lawmakers and drugmakers pushed for increased availability of the drug, considering that around 70% of Americans are affected by obesity or being overweight. The sole manufacturer of Wegovy, Novo Nordisk, aims to improve access and production of the drug.
Further Reading
Learn more about Medicare’s coverage of Wegovy to reduce heart disease risk in this NBC News article.
Read more about Novo Nordisk’s new obesity pill, which beats Wegovy in early trials, in this Forbes article.
Gain insight into Medicare’s decision to cover obesity drugs in this Wall Street Journal article.