Should Medicare and Medicaid eventually cover new weight loss drugs such as Ozempic and Wegovy? This week, Audacy took a look at the issue with Dr. Anand Parekh of the Bipartisan Policy Center.
“In this specific case for obesity medications, unfortunately there’s a statutory prohibition that’s about 20 years old… a time when essentially Congress and policymakers considered weight loss drugs as cosmetic,” he told WWL’s Tommy Tucker. Weight loss drugs are sometimes covered if they are prescribed other issues, such as diabetes or cardiovascular disease.
However, Tucker shared his own experience using the medication as a preventative measure when it looked like he might develop diabetes.
“I lost close to a hundred pounds, I was headed for diabetes. I was knocking on the door of diabetes,” he said.
Parekh said Tucker’s experience echoes the U.S. health system’s focus on treatments rather than preventative measures.
“You know we have our health care policy in this country backwards,” he said.
Even though our understanding of obesity has evolved, Parekh said that congressional approval is still needed to get the medications covered by Medicare and Medicaid. These weight loss drugs glucagon-like peptide 1 (GLP-1) medications and they help curb hunger and manage weight.
Tirzepatide and semaglutide are types of GLP-1 medications. U.S. Food and Drug Administration shortage declarations for the medications recently expired, Tucker noted. Last Month, Audacy reported that the FDA banned compounded versions of GLP-1 medications.
Parekh said there is bipartisan support and that former President Joe Biden’s administration tried to push for coverage of weight loss medications without congressional approval. He said they drafted a proposal to cover the medications that the new administration of President Donald Trump has thus far declined to finalize.
Today, Parekh said prices for the medications are still high – around $9,000 annually. Tucker also explained that Trump has signed an executive order demanding that drug makers cut prices on a variety of medications to more closely match prices in other countries.
“The details are scant, so we don’t exactly know how the administration proposes to do that,” said Parekh. “But, but there is one opportunity… so this year, Medicare can actually now negotiate the price of certain expensive drugs for which there isn’t a lot of competition,” and semaglutide is included on that list.
Still, results of those negotiations won’t kick in for around two years. Parekh said that we will have to “wait and see” if prices come down.
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