Ozempic, Wegovy covered by Medicare and Medicaid under Biden admin proposal for anti-obesity GLP-1 drugs

The Biden administration is expanding coverage of anti-obesity drugs such as Ozempic and Wegovy for people with Medicare and Medicaid through a new proposal from the Department of Health and Human Services, a White House official says. 

Medicare currently only covers these drugs for people who are diagnosed with diabetes or cardiovascular disease with obesity, or for people who are overweight, according to the official, who added that while some state Medicaid programs cover the GLP-1 medications for obesity, many do not. 

The new HHS proposal, they said, would require both Medicare and Medicaid to cover the drugs for people with obesity as a treatment for the condition.

‘Today’s new proposal would expand access to these innovative medications for obesity, which is widely recognized as a disease and help an estimated 3.4 million Americans with Medicare. Medicare coverage would reduce out-of-pocket costs for these prescription drugs by as much as 95 percent for some enrollees,’ the White House said in a statement Tuesday. 

‘Approximately 4 million adult Medicaid enrollees would also gain new access to these medications. This proposal would allow Americans and their doctors to determine the best path forward so they can lead healthier lives, without worrying about their ability to cover these drugs out-of-pocket, and ultimately reduce health care costs to our nation,’ the statement added. 

The White House says that ‘for too many Americans, these critical treatments are too expensive and therefore out of reach,’ and, ‘without insurance coverage, these drugs can cost someone as much as $1,000 a month.’

GLP-1 (glucagon-like peptide) receptor agonists are commonly prescribed to patients with type 2 diabetes (to stabilize blood glucose levels) or obesity (to assist with weight loss). 

‘These medications slow down digestion, which means food stays in the stomach longer,’ said Dr. Alfred Bonati, the founder of the Bonati Spine Institute in Florida, previously told Fox News Digital. 

The White House says an estimated 42 million Americans today have obesity, ‘with increased risk of all-cause mortality and multiple related comorbidities such as diabetes, cardiovascular disease, stroke, some cancers, and more.’ 

‘Over the past few years, there have been major scientific advancements in the treatment of obesity, with the introduction of new life-saving drugs. These anti-obesity medications can help prevent the development of Type 2 diabetes. Furthermore, these drugs reduce deaths and sickness from heart attack and other cardiovascular outcomes by up to 20%,’ the White House added. 

Fox News’ Melissa Rudy contributed to this report.