Will Medicare cover the new GLP-1 weight-loss drugs?

Margot Sanger-Katz, Obesity Drugs Would Be Covered by Medicare and Medicaid Under Biden Proposal, NYTimes, Nov. 26, 2024.

The Biden administration, in one of its last major policy directives, proposed on Tuesday that Medicare and Medicaid cover obesity medications, a costly and probably popular move that the Trump administration would need to endorse to become official.

The proposal would extend access of the drugs to millions of Americans who aren’t covered now.

The new obesity drugs, including Wegovy from Novo Nordisk and Zepbound from Eli Lilly, have been shown to improve health in numerous ways, but legislation passed 20 years ago prevents Medicare from covering drugs for “weight loss.”

The new proposal sidesteps that restriction, specifying that the drugs would be covered to treat the disease of obesity and prevent its related conditions.

“We don’t want to see people having to wait until they have these additional diseases before they get treatment,” said Chiquita Brooks-LaSure, the administrator of the Centers for Medicare and Medicaid Services, or C.M.S., noting the growing medical consensus that obesity is a chronic health condition.

What will the Trump administration do?

Given Mr. Kennedy’s skepticism, and the new drugs’ potentially large cost, Trump officials might not have proposed a coverage requirement. But they may now face pressure to approve it.

Demand for the drugs is strong, and some Medicare beneficiaries are already taking them, even paying full price themselves. A recent survey from KFF, a health policy group, found that 61 percent of Americans support Medicare coverage for these drugs. The Biden administration’s proposal will set off a public comment period, in which doctors and patients will share their views on the decision with government officials.

There's more at the link.