Millions of Medicare beneficiaries struggling with obesity may see a significant reduction in the cost of weight-loss drugs starting July 1, thanks to a new federal pilot program.
The Medicare GLP-1 Bridge program will offer a selection of brand-name medications, including Eli Lilly's Foundayo tablets, Zepbound KwikPens, and Novo Nordisk's Wegovy injections and tablets, for $50 a month to eligible seniors.
Taking place until the end of 2027, this temporary program marks the first time GLP-1s (glucagon-like peptide-1 receptor agonists) will be covered by insurance for weight loss alone.
Under the program's parameters, older adults must have a body mass index (BMI) of 35 or higher when starting GLP-1 therapy, or a BMI of 27 or higher alongside another health condition, such as a past heart attack or stroke or prediabetes.
Those who already receive insurance coverage for other diseases, like diabetes and sleep apnea, will not be eligible for the program.
According to estimates, more than 70 million Americans are currently enrolled in Medicare, with 10 million of them being overweight or obese.
The Medicare GLP-1 Bridge program offers a new, affordable path to FDA-approved treatment for many older Americans living with obesity, who have been waiting for access to these medications.
As part of the program, the Centers for Medicare & Medicaid Services will carefully track participation and outcomes to determine the best course of action for long-term coverage.
A potential concern is that older patients may experience more adverse effects from medication, but further research is needed to fully understand the risks and benefits.
