Medicare has announced it will now cover the weight-loss medication Wegovy for heart disease patients, following FDA approval for its use in reducing cardiovascular risks. This policy change could lead to increased healthcare spending and prescription rates, amidst challenges and a drug shortage.
Medicare has recently announced a policy change allowing coverage for the weight-loss drug Wegovy for heart disease patients, marking a significant shift in its approach to managing obesity and cardiovascular risks. The Centers for Medicare & Medicaid Services specified that Medicare Part D drug plans could include anti-obesity medications like Wegovy for patients deemed in need to lower their risk of serious heart events. This decision comes after the FDA approved Wegovy, a semaglutide-based medication by Novo Nordisk, for reducing the risk of heart attacks, strokes, and other conditions in obese individuals with heart disease, showing a 20% risk reduction compared to a placebo.
The coverage of Wegovy, which carries a monthly cost exceeding $1,300, is expected to increase prescription rates and healthcare spending significantly. However, challenges such as high out-of-pocket expenses, prior authorization requirements, and step therapy may limit patient access. The announcement has been met with support from industry experts and advocates who have long pushed for broader Medicare coverage of obesity drugs. Despite this, a persistent shortage of Wegovy, lasting over a year, remains a hurdle for widespread use, with Novo Nordisk striving to alleviate supply constraints.
In related news, women using weight-loss drugs like Ozempic have reported increased fertility as an unexpected side effect. Stories of “Ozempic Babies” have proliferated on social media, with some mothers attributing their pregnancies to these medications despite contraceptive use. Physicians attribute the boost in fertility to weight reduction restoring ovulatory functions. Novo Nordisk has established the Wegovy Pregnancy Registry to track pregnancies among users due to concerns over potential fetal risks, as the long-term effects of semaglutide on pregnancies are still under investigation. This development has attracted attention and caution from the medical community and the public alike, given the rising popularity of these drugs for weight loss, partly fueled by celebrity endorsements.
