The Biden administration has announced a new proposal to broaden access to anti-obesity medications like Ozempic and Wegovy for individuals enrolled in Medicare and Medicaid. This initiative aims to address the high cost of these drugs, which can be prohibitive for many Americans. Currently, Medicare coverage for these medications is limited to those diagnosed with diabetes, cardiovascular disease with obesity, or those who are overweight. While some state Medicaid programs cover GLP-1 medications for obesity, many do not. The new proposal seeks to change this by requiring both Medicare and Medicaid to cover these drugs for individuals with obesity as a recognized medical condition.
The White House estimates this change will significantly reduce out-of-pocket costs for approximately 3.4 million Medicare beneficiaries, potentially by as much as 95% for some. Additionally, it's projected that around 4 million adult Medicaid enrollees will gain new access to these medications. The administration emphasizes that this proposal empowers individuals and their healthcare providers to make informed decisions about the best course of treatment without the financial burden of high drug costs.
The high cost of these medications, sometimes reaching $1,000 per month without insurance, has been a barrier for many seeking treatment. GLP-1 receptor agonists, the class of drugs these medications belong to, work by slowing digestion, helping to regulate blood glucose levels in patients with type 2 diabetes and aid in weight loss for those with obesity.
With obesity affecting an estimated 42 million Americans and increasing the risk of various health complications, including diabetes, cardiovascular disease, stroke, and certain cancers, the White House highlights the importance of these medications in preventing disease progression. Studies have shown that these anti-obesity drugs can help prevent the development of type 2 diabetes and reduce deaths and illness from heart attacks and other cardiovascular events by up to 20%.
