Millions of Americans with obesity can be eligible popular weight reduction drugs like Wegovy or Ozempic, which can be covered by Medicare or Medicaid under a brand new rule the Biden administration proposed Tuesday morning.
The costly proposal of the US Department of Health and Human Services sets the stage for a possible showdown between the powerful pharmaceutical industry and Robert F. Kennedy Jr., an outspoken opponent of weight-loss drugs as president-elect Donald Trump's The candidate to guide the agency could attempt to block the measure.
While the rule would give thousands and thousands of individuals access to weekly injections which have helped people drop extra pounds so quickly that some are calling them a miracle cure, it might cost taxpayers as much as $35 billion over the following decade.
“It's 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. “It’s a game-changer for Americans who otherwise wouldn’t be able to afford these medications.”
A bipartisan coalition of members of Congress has pushed for the drugs to be covered by Medicare, saying it could save the federal government from spending billions of dollars treating chronic diseases that stem from obesity. While it's unclear how Trump himself feels about coverage of the weight-loss drugs, his allies and Cabinet members who’ve vowed to chop government spending may balk on the upfront price tag.
Under the proposal, only those considered obese – meaning someone with a body mass index of 30 or higher – can be eligible for coverage. Some people may have already got coverage through Medicare or Medicaid in the event that they have diabetes or are susceptible to stroke or heart disease.
Becerra estimated that a further 3.5 million people on Medicare and 4 million people on Medicaid could possibly be eligible for coverage for the drugs. But research suggests that much more people may qualify: The Centers for Medicare and Medicaid Services estimates that about 28 million individuals who receive Medicaid are considered obese.
Medicare is barred from offering the drugs due to a decades-old law that prohibits the government-backed insurance program from covering weight-loss products. However, the Biden administration's proposed rule would recognize obesity as a disease that could be treated with medication.
The obesity drug market has grown significantly in recent times due to the Food and Drug Administration approvingly a brand new class of weekly injectables like Novo Nordisk's Wegovy and Eli Lillyis Zepbound for the treatment of obesity.
People can lose as much as 15 to 25% of their body weight by taking medication. The drugs mimic the hormones that regulate appetite by providing a sense of satiety between the gut and brain when eating.
They have largely limited the associated fee of the drugs to the rich, including celebrities who brag about their advantages. A monthly delivery of Wegovy costs $1,300 and Zepbound gives you $1,000. The lack of medication has also limited supplies.
Kennedy, who’s subject to Senate confirmation as Trump's nominee for HHS secretary, has railed against the drugs' popularity. In speeches and on social media, he said the U.S. shouldn’t fund the drugs through Medicaid or Medicare. Instead, he advocates broadly expanding insurance 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 overweight American,” Kennedy told a bunch of federal lawmakers during a roundtable earlier this 12 months.
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