In order to combat obesity, the Biden administration intends to mandate that Medicare and Medicaid provide coverage for weight-loss drugs.
Proposed by the administration on Tuesday, the new rule would significantly increase access to anti-obesity drugs such as Mounjaro, Ozempic, and Wegovy.
These medications have only been covered by Medicare and Medicaid up until now when they are used to treat diseases like diabetes.
The modification would significantly lower the medications’ out-of-pocket expenses. According to a White House official, the cost of a month’s supply of weight loss medications might now reach $1,000 or higher.
Over 40% of Americans are categorized as obese. The Centers for Disease Control and Prevention state that obesity is a chronic disease that increases the risk of heart disease, diabetes, breathing issues, stroke, and some types of cancer.
According to the White House source, the new regulation would increase access to the medications for an additional 4 million Medicaid enrollees and 3.4 million Medicare beneficiaries.
As of July, the Centers for Medicare & Medicaid Services estimated that 72 million Americans were covered by Medicaid. There are around 68 million Medicare enrollees.
The Kaiser Family Foundation reports that an additional 154 million Americans obtain health insurance through their jobs.
According to research, there are notable differences in the distribution of weight loss medications. Racial differences in access to semaglutide, the active ingredient in Ozempic and Wegovy, were discovered by the health care analytics firm PurpleLab.
According to data from the firm, white people received over 85% of semaglutide prescriptions in 2023. According to experts, the high cost of the medication poses a barrier for many Americans with low and intermediate incomes when insurance does not cover it.
Some discrepancies may be lessened by extending coverage to individuals who are dependent on Medicare and Medicaid.
Dr. Laure DeMattia, a bariatric medicine specialist in Norman, Oklahoma, told NBC News in March that our Medicare and Medicaid populations are among the most vulnerable and lack access to anti-obesity medications.
As the medications’ popularity grows and businesses attempt to balance program expenses with the requirements of their employees, the issue is quickly turning into a workplace concern as well.
Less than a quarter of major U.S. corporations provided health insurance policies that included weight reduction medications, according to survey data that were published in Health Affairs last month.
Semaglutide injections are used in weight loss treatments such as Wegovy. The medications function by imitating the GLP-1 hormone, which regulates blood sugar, controls metabolism, and promotes feelings of fullness.
Numerous new GLP-1 medications are being developed by pharmaceutical companies, who are also researching their potential benefits for treating various illnesses and evaluating their long-term consequences.
According to studies, among other things, these medications may help people reduce alcohol consumption and sleep apnea.
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