Medicare opens first weight-loss coverage at $50 a month
A new pilot Medicare program, "set to continue through 2027, will allow older adults to access GLP-1 medications for $50 per month" — the first time the program will cover them specifically for weight loss,
The federal government took its biggest step yet to defray the cost of GLP-1 drugs for seniors. Medicare currently covers Wegovy, Zepbound and similar drugs only for cardiovascular and severe fatty-liver indications. But a new pilot, "set to continue through 2027, will allow older adults to access the medications for $50 per month" — the first time the program will cover them specifically for weight loss.
The pilot lands as Novo Nordisk simultaneously rolls back list prices for insured Americans. The retail price of Wegovy at U.S. pharmacies is roughly $1,350 a month, Reuters reported, "however, Novo has indicated plans to lower the price to $675 in 2027."
Consumers paying cash can already get Wegovy for 149 dollars a month through manufacturer programs. Novo announced Monday it will slash GLP-1 list prices for insured patients "by up to 50 percent" to relieve people with high-deductible health plans or coinsurance designs, CNBC reported, and Bloomberg reported twice as many Medicare patients prefer the company's coming GLP-1 pill to its weekly shot.
The economic stakes are enormous.
Bloomberg reported U.S. health spending is set to top 6 trillion dollars this year, with GLP-1 drugs the single biggest driver. China approved Pfizer's GLP-1 drug Xianweiying for long-term weight management this week, Reuters reported, opening a second-mover U.S. competitor.
And research showed GLP-1 medications, including Ozempic and Mounjaro, "can prevent the formation of new substance use disorders and alleviate existing addictions," according to a large study of U.S. military veterans, Reuters reported.
