Millions of Americans suffering from obesity could benefit from popular weight-loss drugs like Wegovy Or Related to Zep covered by Medicare or Medicaid under a new rule proposed by the Biden administration Tuesday morning.
The costly proposal from the U.S. Department of Health and Human Services immediately sets the stage for a showdown between the powerful pharmaceutical industry and Robert F. Kennedy Jr., an outspoken opponent of the project. weight loss drugs who, as President-elect Donald Trump’s nominee to head the agency, could block the measure.
Even though this rule would give millions of people access to weekly injectables that have helped people lose weight so quickly that some have called them miracle drugs, it would cost taxpayers as much as $35 billion over the course of of the next decade.
“This is a good day for anyone who suffers from obesity,” U.S. Health and Human Services Secretary Xavier Becerra said in an interview with The Associated Press. “This is a game-changer for Americans who otherwise could not afford these medications.”
The rule won’t be finalized until January, days after Trump takes office. A bipartisan coalition of members of Congress has pushed for the drugs to be covered by Medicare, saying it could save the government from spending billions of dollars to treat chronic diseases linked to obesity. Although Trump himself’s position on coverage of weight-loss drugs is unclear, his allies and Cabinet picks who have pledged to cut government spending may balk at the upfront price tag.
Under the proposal, only people considered obese, meaning people with a body mass index of 30 or higher, would be eligible for coverage. Some people may already have drug coverage through Medicare or Medicaid if they have diabetes or are at risk for stroke or heart disease.
Receive weekly health news
Receive the latest medical news and health information every Sunday.
Becerra estimated that an additional 3.5 million people on Medicare and 4 million people on Medicaid could qualify for drug coverage. But research suggests many more people could qualify, with the Centers for Medicare and Medicaid Services estimating that about 28 million people on Medicaid are considered obese.
Medicare is barred from offering these drugs under a decades-old law that prohibits the government-backed insurance program from covering weight-loss products. The Biden administration’s proposed rule, however, would recognize obesity as a disease that can be treated with medication.
The market for anti-obesity drugs has grown significantly in recent years, with the Food and Drug Administration approving a new class of weekly injectables like Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound to treat obesity.
People can lose up to 15 to 25 percent of their body weight with these medications, which mimic hormones that regulate appetite by communicating fullness between the gut and brain when people eat.
The cost of the drugs has largely limited them to the wealthy, including celebrities who boast of their benefits. A monthly supply of Wegovy costs $1,300 and Zepbound will run you $1,000. Drug shortages have also limited supplies.
Kennedy, who as Trump’s nominee for HHS secretary must be confirmed by the Senate, denounced the popularity of these drugs. In speeches and on social media, he has said the United States should not cover drugs through Medicaid or Medicare. Instead, he supports a broad expansion of coverage for healthier foods and gym memberships.
“For half the price of Ozempic, we could buy regeneratively grown organic food for every American, three meals a day, and a gym membership for every obese American,” Kennedy told a group of lawmakers federal officials at a roundtable earlier this year. Ozempic is a diabetes medication that can boost weight loss.