On March 8, 2024, boxes of Ozempic and Wegovy produced by Novo Nordisk can be seen in a pharmacy in London, England.
Holly Adams | Reuters
Millions of Americans with obesity will be eligible Popular weight loss pills Wegovy or Ozempic, among others, would be covered by Medicare or Medicaid under new rules proposed by the Biden administration Tuesday morning.
The expensive proposal comes from U.S. Department of Health and Human Services Setting the stage for a potential showdown between the powerful pharmaceutical industry and Robert F. Kennedy, Jr. As president-elect, he was an outspoken opponent of diet pills Donald Trump’s The nominee to lead the agency may try to block the measure.
While the rule will cost millions of people over the next decade a weekly shot that helps people lose weight so quickly that some are calling it a miracle drug, it will cost taxpayers over the next decade Spending up to $35 billion.
“This is a great day for anyone living with obesity,” U.S. Health and Human Services Secretary Xavier Becerra said in an interview with The Associated Press. “For those who can’t afford these medications, For Americans, this is a game changer.”
A bipartisan coalition of members of Congress has been lobbying for the drugs to be covered by Medicare, saying it could save the government billions of dollars spent treating chronic diseases caused by obesity. While it’s unclear where Trump himself stands on diet pill coverage, his allies and Cabinet picks who have vowed to cut government spending may balk at the upfront price.
Under the proposal, only those considered obese (with a body mass index of 30 or higher) would be eligible for coverage. If some people have diabetes or are at risk for stroke or heart disease, they may already have coverage for these drugs through Medicare or Medicaid.
Becerra estimates that another 3.5 million people with Medicare and 4 million with Medicaid are eligible for coverage of these drugs. But research shows that many more people may qualify, and the Centers for Medicare and Medicaid Services estimates that about 28 million people on Medicaid are considered obese.
Medicare is prohibited from covering the drugs under a decades-old law that bars government-backed insurance plans from covering weight-loss products. However, the rules proposed by the Biden administration would recognize obesity as a disease that can be treated with medication.
The anti-obesity drug market has expanded significantly in recent years with the approval of the U.S. Food and Drug Administration approve A new class of weekly injections, such as Novo NordiskWego peacekeeping Eli Lilly and CompanyZepbound treats obesity.
People can lose up to 15% to 25% of their body weight by taking these drugs, which mimic hormones that regulate appetite by communicating feelings of fullness between the gut and brain when people eat.
The cost of these drugs has largely limited access to the wealthy, including celebrities who tout their effectiveness. Wegovy’s monthly supply is $1,300, while Zepbound’s monthly supply is $1,000. Drug shortages are also limiting supplies.
Kennedy, Trump’s nominee for Health and Human Services secretary who needs to be confirmed by the Senate, has criticized the popularity of the drugs. He said in speeches and on social media that the United States should not cover these drugs through Medicaid or Medicare. Instead, he supports broad expansion of access to healthy food and gym memberships.
“We could buy every American regenerative organic food at half the price of Ozempic, three meals a day and a gym membership for every obese American,” Kennedy told a group of federal lawmakers at a roundtable earlier this year. qualifications.
