Topline
Medicare and Medicaid would cover weight-loss drugs like Wegovy and Ozempic under a new rule proposed by President Joe Biden on Tuesday, increasing access to the widely popular medications to millions of adults with obesity in the U.S., though the plan would likely face opposition under President-elect Donald Trump's second administration.
Millions of adults with obesity in the U.S. would have increased access to the widely popular drugs.
Key Facts
Under the proposal, those who are considered obese—anyone with a body mass index of 30 or higher—would qualify for coverage under Medicare and Medicaid, while others may already be covered if they have diabetes or are at risk of stroke or heart disease, the Biden administration announced.
Medicare has been prohibited from covering weight-loss products under the Medicare Modernization Act, though the new Biden administration proposal would recognize obesity as a disease that could be treated by the medications.
The new rules, which the Department of Health and Human Services has yet to outline, would likely be finalized in January, just days after Trump takes office, according to the Associated Press.
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Big Number
7.4 million. That’s how many adults with obesity would have coverage for weight-loss drugs under Medicare and Medicaid under Biden’s proposal, according to the administration. Of these, about 3.4 million would be covered by Medicare and roughly 4 million would be covered by Medicaid.
What We Don’t Know
Whether the Trump administration will leave the policy in place or seek to block it—especially since Trump’s top health picks have expressed varying views on weight loss drugs.
What Has Rfk Jr. Said About Ozempic?
Robert F. Kennedy Jr., tapped by Trump to lead the Department of Health and Human Services, has largely opposed weight-loss drugs like Ozempic. In an interview with Fox News in September, Kennedy disputed studies indicating the additional benefits of Ozempic and Wegovy—including some that found they also combatted alcoholism—and claimed expanding access to the drugs would cost the U.S. about $3 trillion. Kennedy also claimed the European Union was investigating Ozempic’s links to an increase in suicidal thoughts, though the EU’s drug regulator and the Food and Drug Administration have found no evidence supporting the claims. Kennedy argued the U.S. could instead supply Americans with healthy food, which he said could “solve the obesity and diabetes epidemic overnight.”
What Has Dr. Oz Said About Ozempic?
Dr. Mehmet Oz, nominated by Trump as head of the Centers for Medicare and Medicaid Services, has promoted the weight-loss effects of drugs like Ozempic. In 2021, Oz—a surgeon-turned-television personality—carried a cinder block onto his set to show the average amount of weight lost by patients in a clinical trial for Ozempic. Despite warning the long-term effects of these drugs were not yet known, Oz also celebrated other studies indicating the medications could serve other purposes, including treatment for alcohol-use disorder.
Key Background
Expanding coverage to weight-loss drugs like Novo Nordisk’s Wegovy and Ozempic has been promoted by bipartisan efforts in recent months. The House Ways and Means Committee voted to lift a decades-old ban on weight-loss products being covered by Medicare for some patients in June, after a group of House lawmakers from both parties proposed expanding coverage to anyone with a prescription for more than a year. The Biden administration has also proposed negotiating to reduce prices to other widely used prescriptions covered by Medicare, including some medications for diabetes, chronic kidney disease and heart failure, among others. In February, the White House said Medicare officials submitted initial offers to the manufacturers of those drugs to lower their prices, in a move the administration said would save the health program nearly $100 billion over a decade. The Biden administration also capped the price of one-month and three-month supplies for insulin at $35, cutting down the costs for drugs like Novo Nordisk’s Fiasp ($579) and NovoLog ($81).
Amgen Reports Weight Loss Drug Results—but Shares Slide
Amgen announced Tuesday its experimental weight-loss injection helped patients with obesity lose up to 20% of their weight in a mid-stage trial. MariTide, which Amgen said would be taken monthly or less frequently, also “significantly reduced” symptoms like nausea and vomiting as patients increased their dosage. Despite the findings, analysts in an investor call with Amgen said the data was “in line” with already available medications like Novo Nordisk’s Ozempic or Eli Lilly’s Mounjaro. Amgen’s shares fell by more than 11% after trading opened on Tuesday.
