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GLP-1 Drug Coverage Growing For Obesity In Medicaid, But Only For Diabetes In Medicare

 
• By Cathy Kelly

Coverage data from the two programs suggest Medicare beneficiaries may be more disappointed than Medicaid enrollees by the Trump Administration’s decision not to mandate the programs cover obesity drugs.

Obesity drugs will not receive the required access in government sponsored insurance ... yet. (Shutterstock)
Key Takeaways
  • Coverage of GLP-1 drugs for obesity are expanding in Medicaid even though coverage for the indication still is almost nonexistent in Medicare Part D, according to recent MMIT data.
  • The data suggest the Trump Administration’s recent decision to drop the Biden-era proposal to expand obesity drug coverage in the programs may be more disappointing to Part D beneficiaries.
  • Cost likely was the key reason for the decision, especially as the administration appears poised to implement significant cuts in the Medicaid program, former CMS official John Coster said.

A review of current and year-ago coverage policies for GLP-1 drugs in Medicare and Medicaid suggests the Trump Administration’s decision not to continue with a proposal to require coverage of...

The coverage policies pertain to Novo Nordisk’s two semaglutide drugs, Wegovy for obesity and Ozempic for type 2 diabetes, and

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