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Slimmed-Down Obesity Drug Coverage In Medicare: First Step Or False Start?

 
• By Michael McCaughan

A US House of Representatives bill to provide obesity drug coverage to a very select group of Medicare beneficiaries, passed only after Democrats debated whether the proposal is a “first step” towards broader coverage or a misstep counter to Medicare’s goals.

weight loss drug
A bill that would allow coverage of obesity drugs for some Medicare beneficiaries, but not all, created a dilemma for Democrats. • Source: Shutterstock

A new bill to expand Medicare coverage for obesity medicines in the US poses quite a dilemma for supporters of the idea that modern weight loss drugs should be available for the elderly and disabled under the federal health insurance program.

Key Takeaways

  • A bill allowing those who had private insurance coverage of obesity medication to continue coverage upon enrolling in Medicare could create a haves and have-nots system, House Democrats said.

The new version of the Treat and Reduce Obesity Act vastly differs from the original version, which would have eliminated...

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More from Medicare

PCMA, CVS, Cigna File Lawsuits Over ‘Dangerous’ Arkansas PBM Law

 
• By Tim Casey

The suits are an early test of the Arkansas law banning company ownership of PBMs and pharmacies in the state, as other states consider similar legislation.

Medicare Part D LIS Access Threatened By House Budget Bill’s Medicaid Obstacles

 
• By Cathy Kelly

An unintended consequence of a provision framed as an administrative change in the bill could significantly reduce medication adherence among low-income older adults and increase mortality, a study found.

Saving Part D: US Medicare Advisors Sound The Alarm

 
• By Michael McCaughan

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GLP-1 Pricing ‘Paradigm Shift’ Possible, But Would It Meet Trump’s MFN Goals?

 
• By Cathy Kelly

For the Trump Administration, the blockbuster GLP-1 drugs for obesity have become a poster child for the disparity between US and foreign prices.

More from Government Payers

Crisis Or Opportunity? US MFN Policy Could Test Japan’s Appetite For Reforms

 
• By Lisa Takagi

While the adoption of most favored nation drug pricing in the US stands to affect Japanese biopharma firms now heavily reliant on this market, it might also present an opportunity for pricing and policy reforms at home.

Payment Cap Not Always Solution For Unaffordable Drugs, Maryland PDAB Director Says

 
• By Cathy Kelly

The state's Prescription Drug Affordability Board, the oldest of a growing list of the boards, chose six drugs for affordability reviews and has the authority to set a ceiling on the amount state and local government payers would reimburse for them.

Saving Part D: US Medicare Advisors Sound The Alarm

 
• By Michael McCaughan

The US Medicare Payment Advisory Commission worries that Medicare prescription drug market trends may cause the stand-alone plan portion of the program to “wither away,” which could take the traditional fee-for-service side of Medicare with it.