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Medicare to Cover Weight Loss Drugs: A Game Changer for Seniors
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medicare’s decision to cover popular weight loss drugs like Ozempic and Wegovy could dramatically reshape obesity treatment, and it’s already setting the stage for eli Lilly’s upcoming launch of a new obesity pill, orforglipron.
Medicare’s Coverage Shift: A Game Changer for Weight Loss
Expanded Medicare coverage for GLP-1 medications is poised to significantly increase access to obesity treatment and influence the pharmaceutical market.
- Approximately 41.9 percent of U.S. adults were obese between 2017 and 2020, according to the CDC.
- Medicare will begin covering GLP-1 drugs, potentially lowering copays to $50 per month.
- eli lilly anticipates Medicare coverage for orforglipron “instantly following” its launch.
- The expanded coverage could impact 20-30 million Medicare beneficiaries.
For years, effective weight loss medications have been largely out of reach for many seniors. That’s about to change.The Centers for disease Control and Prevention reported that from 2017 to 2020, 41.9 percent of U.S. adults were obese, and roughly 9.2 percent were considered severely obese. now, with Medicare beginning to cover these medications, a important barrier to access is falling away.
What to Expect with Expanded Coverage
Eli Lilly CEO Dave Ricks recently stated that the company will have Medicare coverage “immediatly following” the launch of orforglipron,predicting this will “change the game.” Currently, many patients seeking weight loss assistance with GLP-1s, like Novo Nordisk’s Wegovy, often pay upfront in cash. Ricks expressed confidence that Eli Lilly’s pill will be competitive, with a full launch anticipated in the second quarter, coinciding with Medicare’s new coverage rollout.
The new rules, stemming from deals between Eli Lilly, Novo Nordisk, and the Trump governance, could mean Medicare patients pay just $50 per month in copays for both injectable and oral GLP-1 drugs. Ricks estimates that between 20 million and 30 million Medicare beneficiaries are obese, making the expanded coverage a “big multiplier on the eligible pool.”
