Weight-loss Companies Want Medicare Coverage

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Big Pharma thinks Medicare should be paying for your weight-loss drugs.

Companies behind diet medications like Wegovy and Mounjaro are lobbying Congress to get their medications covered under Medicare, which would give a boost to already blockbuster sales.

Oh, Oh, Oh

Danish medical company Novo Nordisk debuted Ozempic in 2017 as a once-weekly diabetes treatment, but the medication quickly skyrocketed in popularity among Hollywood celebrities and viral TikTokers looking to maintain a beach bod year round. Doctors also began prescribing it to overweight patients who didn’t have diabetes, resulting in shortages for actual diabetics. But Novo Nordisk execs can sleep easy knowing the company’s stock has increased 125% in the past five years and the brand’s market cap sits at $380 billion.

In 2021, the US Food and Drug Administration approved the formula as a weight loss medication, a designation Eli Lilly is still trying to obtain for its product, Mounjaro. Novo Nordisk started distributing the drug under two names – Ozempic for diabetes and Wegovy for weight loss.

Never ones to skimp on lobbying, pharmaceutical companies are increasing their spending as the demand for their weight-loss drugs ramps up:

  • Novo Nordisk has spent decades calling on Congress to approve Medicare coverage for weight-loss drugs. It has also spent an average of $3 million a year on those efforts since 2013, The Wall Street Journal reported. Last year, the company dropped $4.6 million on lobbying.
  • Wegovy would cost uninsured patients more than $10,000, and Novo Nordisk argues that the potential health benefits to the 65 million senior citizens enrolled in Medicare should be enough for the program to cover weight-loss drugs.

Coverage For Some, But Not All: Unfortunately for Big Pharma, Congress doesn’t seem to be interested in giving the go-ahead for weight-loss drugs. Even lawmakers who support covering the medications are finding the cost difficult to bear. Sources told the WSJ that legislators like Sen. Bill Cassidy (R., La.) are working with the Congressional Budget Office to bring prices down and are proposing only limiting coverage to people with higher body mass indexes.