7.4 million Americans could gain Medicare or Medicaid coverage for anti-obesity drugs under Biden proposal

Millions more senior citizens and lower-income Americans could obtain coverage for costly anti-obesity drugs under a proposal being unveiled Tuesday by the Biden administration.

Millions more senior citizens and lower-income Americans could obtain coverage for costly anti-obesity drugs under a proposal being unveiled Tuesday by the Biden administration. Some 3.4 million Medicare beneficiaries and about 4 million Medicaid recipients would gain access to these medications, which can cost as much as $1,000 a month for the uninsured, the White House said in a fact sheet. Some Medicare enrollees could see their out-of-pocket costs drop by as much as 95%. “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 administration said. The White House announcement lacked many details about the proposed rule, including which drugs are included, who would qualify and how much it would cost. It’s also unclear whether the proposal can be finalized before President Joe Biden leaves office in January. The high cost of anti-obesity drugs, including the GLP-1 medicines Wegovy and Zepbound, has limited Americans’ access to the medications. The list price for Wegovy, for instance, is about $1,350 for a four-week supply. Medicare is prohibited by law from covering drugs for obesity. But the Centers for Medicare and Medicaid Services opened the door to coverage of Wegovy for Medicare enrollees in March after the US Food and Drug Administration approved the drug for adults with cardiovascular disease who are either obese or overweight. Several insurers that provide Medicare Part D drug plans have since said they would cover the medication.