Trump rejects the Medicare proposal to cover Wegova and other obese drugs

On Friday, Trump’s administration rejected the Biden plan that would require Medicare and Medicaid to cover obesity drugs and extend access to millions of people.

According to the law, which established benefits from part D Medicare, the program was forbidden to pay for medicines for “weight loss”. But the proposal of Biden administration in November last year tried to bypass this ban, arguing that drugs would be able to treat obesity and related conditions.

Increasing the range of drugs would cost billions of dollars of the federal government. Congress Budget Office estimated The federal cost would be around $ 35 billion in 10 years.

The decision announced on Friday was part Larger 438-page regulation By updating the parts of Medicare in part D. Party Drug and Medicare Advantage, private insurance is currently planning about half of Medicare beneficiaries.

Catherine Howden, a spokeswoman for Centers for Medicare and Medicaid Services, said that the agency thought that the insurance extension “is currently not suitable.” She said, however, that the agency did not rule out coverage and “may consider future drug options” drugs.

Medicare, a government insurance program for Americans over 65 years of age and disabled people, includes slimming drugs for diabetic patients and for a much smaller number of obese people, and also have heart problems or sleep apnea.

The Biden plan would have extended obese patients, but they did not have these diseases. Medicare officials estimated that about 3.4 million people decided to take drugs within the policy.

The most popular slimming drugs are produced by Novo Nordisk, who sells his medicine as Wegova for obesity and ozmpic for diabetes and Eli Lilly, who sells his product as Zepbound for obesity and munjaro for diabetes.

Eli Lilly and Novo Nordisk now offer their products USD 350 Down $ 500 A month for patients who pay their own money instead of going through insurance. But until recently, patients sometimes paid over 1300 USD per month.

Robert F. Kennedy Jr., Secretary of Health, was loudly criticized in the field of slimming drugs, saying that they are worse than consuming hearty food.

Drugs have been demonstrated in clinical studies that benefit far beyond weight loss, such as preventing heart attacks and strokes.

Supporters of extended insurance argued that government expenditure on drugs will at least partially pay off in the long run. They say that patients would become healthier, which will prevent exorbitant medical accounts. It is not clear yet whether such savings materialize.

Medicaid state programs that provide health care for the penniless can now choose whether to cover medicines and Some do. If Biden’s wider policy were finalized, insurance would be required in every state.

Obesity drugs cost Medicare and Medicaid hundreds of dollars per patient each month, although the exact prices are secret.

Many employers and private health insurance plans do not include drugs. Some, including the state plans of employee benefits in North Carolina and West Virginia, abandoned the range of drugs after their popularity, citing high costs.

Without insurance protection, many patients with Medicare and Medicaid relied on inexpensive versions of imitative drugs produced as part of the drug mixing process known as a computer. These versions that were allowed because branded drugs were briefly stocked can cost less than USD 200 per month. But regulatory authorities ordered such sales Finish soon Because the supply of branded products has improved.

Republicans in Congress expressed interest in the requirement of medicare to cover medicines. The idea was included in the list of policy options developed by the House budget committee at the beginning of this year. But currently this does not seem to be the main priority.

In order to reduce the costs, Medicare chose Wegova Novo Nordisk to negotiate on lower prices on the basis of the Act adopted by the Democratic Congress controlled by the Democratic Congress in 2022. These lower prices would start for qualifying persons in 2027, a change that may reduce long -term protection costs.