When Will Medicare Cover Weight Loss Drugs

Ann Arbor, MI—A large majority of older Americans believe that Medicare should cover weight loss drugs, according to a new survey. The problem is that a law passed in 2003 prohibits Medicare from covering weight loss medications, although an exception is made for patients with type 2 diabetes. Other federal programs have more leeway, with Medicaid covering obesity medications for adults with low incomes in 15 states. The Veterans Health Administration, as with most private plans, provides coverage but adds restrictions due to high monthly costs for the new generation of medications.Still, according to a recent University of Michigan National Poll on Healthy Aging survey, 83% of older adults who responded said they feel health insurers should cover medications that can help people with obesity manage his or her weight, while 76% said Medicare should do that.The poll sought to determine the interest of older adults in taking prescription medications for weight management. Among the 27% of respondents aged 50 to 80 years who describe themselves as overweight, 63% said they were interested in taking such medications. A similar response came from 45% of those with diabetes, even if they were normal weight. Among adults who had ever taken a weight loss medication before, 83% said they would do so again.“Our data show the strong awareness and interest in these medications, and in access to them through insurance, alongside coverage for other weight-focused care including nutrition counseling, exercise programs and bariatric surgery,” said Lauren Oshman, MD, MPH, an obesity medicine specialist and associate professor in the University of Michigan Department of Family Medicine, who worked on the poll.“We hope these findings will help inform policymakers and benefit plan designers who are grappling with the tradeoffs of cost and long-term benefit when it comes to these medications,” Dr. Oshman added. The poll was supported by AARP, as well as Michigan Medicine, the University of Michigan’s academic medical center.The poll was timely because of the growing awareness—from news and social media reports—of injectable glucagon-like peptide 1 (GLP-1) medications such as Ozempic, Wegovy, Mounjaro, and Zepbound.The poll finds that 61% of respondents had heard of Ozempic, which has FDA approval only for use in people with diabetes but has been used off-label for weight loss. Interestingly, it contains the same active ingredient as Wegovy, which is approved for use in obesity, and only 18% of older adults have heard of it.The next most familiar weight loss drug was the older product, phentermine, which 13% of older adults have heard of. In addition to being prescribed alone, it is also available as part of the combination medication sold as Qsymia, which 3% of older adults had heard of. About 3% had heard of Saxenda or Contrave. The obesity-specific form of the GLP-1 drug Mounjaro, Zepbound, received FDA approval for weight management after the poll was taken.Relatively few of the respondents said they had discussed the drugs with healthcare providers.Dr. Oshman pointed out that in the new poll, nearly all older adults said they had tried to lose weight in the past, including large percentages who said they had exercised or changed his or her diet.The poll report is based on findings from a nationally representative survey conducted by the National Opinion Research Center at the University of Chicago for the Institute of Healthcare Policy and Innovation, administered online and via phone in July and August 2023, among 2,657 adults aged 50 to 80 years. The sample was subsequently weighted to reflect the U.S. population study.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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