Medicare Partially Covers Weight Loss Drugs Amidst High Price Concerns and Future Negotiation Prospects

1. Medicare Part D plans can now cover the cost of anti-obesity medications like Novo Nordisk's Wegovy (semaglutide).
2. High pricing of these drugs raises concerns about affordability and accessibility for Medicare beneficiaries.
3. The Inflation Reduction Act allows for drug price negotiation after certain requirements are met; Wegovy might become a candidate for negotiation in the future.
4. The high cost of these drugs could lead to increased Part D premiums, affecting federal spending on Medicare Part D.
5. Utilization management tools, such as prior authorizations and step therapies, may limit access to these medications.
6. Healthcare analysts predict that Novo Nordisk's semaglutide (Wegovy) will be chosen for price negotiation within the next few years, which could lower the cost of legislation requiring Medicare to cover obesity drugs.
7. The Biden administration has already released the first 10 drugs for price negotiations, which will take effect by 2026; Ozempic (another Novo Nordisk drug) may be included in future rounds due to its high expenditure on Medicare Part D.