The price of Wegovy will quickly be coated by Medicare, in accordance with an announcement from the federal medical insurance program for seniors on Thursday. And whereas that’s nice information for folks over 65 who need entry to a drugs that’s drawn a lot consideration for its capacity to help with weight loss, there’s only one catch. Medicare will solely pay if sufferers have probably severe coronary heart issues.
Wegovy is the model title of Novo Nordisk’s anti-obesity remedy semaglutide, first accepted within the U.S. in 2021. And together with Ozempic, which can be made by Novo Nordisk, the medication have turn out to be hot-ticket objects for folks trying to reduce weight. However the price of Wegovy, which might be over $1,300 a month, has been prohibitively costly for a lot of Individuals.
Wegovy was discovered to cut back coronary heart assaults and strokes in a serious trial last summer, paving the best way for the FDA to approve medical doctors having the ability to prescribe the remedy for that objective earlier this month.
A spokesperson with Novo Nordisk, which is predicated in Denmark, informed Gizmodo on Thursday the corporate is inspired by the brand new steerage from the Facilities for Medicare and Medicaid Providers, however pressured that weight problems alone was a difficulty that ought to get correct consideration when the federal government is providing this type of monetary assist.
“Wegovy is the one weight administration medication that can be accepted to cut back the threat of main antagonistic cardiovascular occasions in sufferers with established heart problems and both weight problems or chubby. However there’s extra work to be finished as a result of Half D protection remains to be not accessible for weight problems medicines when used for persistent weight administration,” the Novo Nordisk particular person wrote.
The Inflation Discount Act, handed in 2022, included quite a few new provisions to assist these on Medicare, together with a brand new cap on prescription drug prices of $3,000 that takes impact this 12 months. That change will assist about 1 million seniors who pay for extremely pricey medication generally utilized in most cancers sufferers.
However even with constructive modifications just like the Inflation Discount Act, the price of medication within the U.S. remains to be astronomically excessive in comparison with different international locations. And these sorts of enhancements assist these on Medicare, the fee is borne by the taxpayer relatively than by a negotiation of decrease costs typically achieved in peer international locations. Medicare was banned from negotiating costs on most medication in 2003, a disastrous legislation that’s now being slowly rolled again by laws championed by Democrats and President Joe Biden.
The Related Press factors on the market’s severe debate about whether or not Medicare ought to cowl anti-obesity medication like Wegovy, actually because it’s not clear whether or not the excessive costs paid by the federal government will probably be offset by decreases in prices for treating obesity.
“We’ll proceed to advocate for insurance policies that allow entry to weight problems medicines for the numerous sufferers who don’t but have protection,” Novo Nordisk informed Gizmodo. “Collaboration throughout the healthcare system is vital to teach and to broaden protection of weight problems medicines.”
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