Forbes April 1, 2024
The weight loss drug Wegovy secured a supplemental cardiovascular indication from the Food and Drug Administration last month. This allows for limited access to the drug for certain Medicare beneficiaries who fulfill weight and major cardiovascular risk criteria.
Currently, Medicare is prohibited by law from covering medications for obesity. Congress is unlikely to lift the prohibition any time soon. And merely 20% of state Medicaid agencies permit coverage of weight loss drugs.
However, because a cardiovascular indication to prevent heart attacks or strokes was added last month to an already approved obesity drug, Wegovy (semaglutide), this paves the way for coverage by health plans operating in the Medicare Part D (outpatient) program. These plans may now cover Wegovy for patients...
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