Medicare Will Cover Wegovy For Eligible Members
Topline
Medicare will soon cover popular weight loss drug Wegovy for its members, as long as they have heart disease and an increased risk of heart attack and other cardiovascular issues, the federal health insurance program confirmed with Forbes on Thursday, bucking the agency’s trend of not providing coverage for weight loss drugs.
Wegovy is manufactured by Novo Nordisk. (Photo by: Michael Siluk/UCG/Universal Images Group via … [+]
UCG/Universal Images Group via Getty Images
Key Facts
Medicare issued guidance Thursday allowing Medicare Part D plans, which are offered by private insurers and cover costs for medications taken at home, to cover weight loss drugs as long as they treat diabetes or reduce risks of cardiovascular problems in adults who have heart disease, obesity or are overweight.
Wegovy, an injectable weight loss drug designated for adults with cardiovascular risks and obesity, falls within the new guidance, allowing it to be approved for coverage under Medicare Part D.
The drug won’t be covered for Medicare members seeking to purely use it for weight loss.
Wegovy’s eligibility under the plan could mark the start of thousands of prescriptions for adults and billions of dollars in increased spending, the Associated Press reported.
51.5 million people were enrolled in Medicare Part D as of March last year, according to government data.
Big Number
Around $1,200. That’s Wegovy’s approximate list price.
Key Background
Wegovy was approved by the Food and Drug Administration earlier this month after receiving a priority review designation from the agency, making it the first weight loss drug ever to also be approved to help prevent cardiovascular problems. The approval was made following a push by lawmakers and drugmakers to increase the drug’s availability for Americans, approximately 70% of whom are affected by obesity or being overweight, according to the FDA. Wegovy’s sole manufacturer, Novo Nordisk, has said it’s seeking to increase access and production to the drug, the Associated Press reported. Novo Nordisk’s stock is up more than 76% in the past year and now trades around $129 per share.
Further Reading
Medicare will cover Wegovy to reduce heart disease risk (NBC News)
Novo Nordisk’s New Obesity Pill Beats Wegovy In Early Trial (Forbes)
Medicare Opens Door for Covering Obesity Drugs (WSJ)
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