Few medications have made the kind of dramatic entrance to the public sphere that semaglutide (GLP-1) and tirzepatide (GIP) have, at least in the last 75-100 years.
First, there was penicillin. Then there was insulin and the birth control pill.
And now there is Ozempic.
“I’ve said this before, but as more data comes in I become more convinced that we may look back on these drugs as the greatest medical breakthrough of the 21st century. I’m serious.” That was a statement Clinical and Translational Research Accelerator at Yale, F. Perry Wilson, MD, MSCE.
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Dr. Wilson’s statement might sound hyperbolic, but the United States has seen nearly continuous rises in obesity rates for decades. However, for the first time in years, in 2023, rates fell, and some experts believe the drop was partly due to the increasing use of semaglutide or tirzepatide (aka GLP-1 or GIP), medications.
Ozempic, Mounjaro, Zepbound and Wegovy are the brand names of some of the most popular medications.
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These drugs all mimic a hormone that reduces hunger. They have also shown promise in treating everything from kidney and cardiovascular disease to addiction and Alzheimer’s. The drugs have been in such demand that there were shortages last year, although manufacturers now seem to have caught up.
Wegovy is the brand name of one of the most popular drugs currently being used to treat obesity.
James Manning/Getty Images
Americans are clamoring for access to weight-loss drugs
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About 12% of US adults — that’s around one in eight — have reported ever using a GLP-1 drug, with 6% currently using them, according to a KFF Health Tracking Poll. These drugs are very expensive: without insurance, they can cost over $1,000 a month.
Now, millions of Americans with government-backed insurance may not be able to receive help covering the treatment.
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Medicare currently only covers these drugs for people who have diabetes or heart disease. Most state Medicaid programs do not cover them solely for obesity.
The Biden administration hoped to extend coverage to around 3.4 million Medicare recipients who are obese, plus another 4 million Medicaid recipients. However, the drugs would cost Medicare $24.8 billion over 10 years and Medicaid another $14.8 billion over 10 years. The costs would mostly fall on the federal government.
The White House does not intend to cover the drugs for Medicare and Medicaid recipients, at least for now
The Trump administration announced on Friday it had rejected a Biden-era proposal to expand Medicare and Medicaid coverage to include popular anti-obesity medications (AOMs) like Wegovy and Zepbound, according to a statement from the Centers for Medicare & Medicaid Services (CMS).
The administration said it would be open to revisiting its decision in coming months.
Spokespeople for the manufacturer of Zepbound — Indianapolis-based Eli Lilly (LLY) — and the manufacturer of Wegovy — Denmark-based Novo Nordisk (NVO) — said the decision is disappointing and restrictive to patient access, according to a Bloomberg report.
“It is not the best reading of the statute and impacts patient access to obesity treatments,” a Lilly spokeswoman said in response to Friday’s decision. Novo Nordisk expressed similar disappointment, adding, “It is essential that CMS regulations are aligned with current medical science — and that means recognizing obesity as a serious chronic disease.”
Shares in both companies dropped on Friday following the news.
In recent weeks, Health Secretary Robert F. Kennedy Jr. has criticized the reliance on using medication to treat obesity, promoting diet-based solutions instead.
Elon Musk’s Department of Government Efficiency also emphasized cutting federal spending, including in healthcare and this decision is likely part of that push.
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