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Medicare will soon make the popular weight loss drug Wegoby available to members only if they have heart disease and are at high risk for heart attack or other cardiovascular disease, the federal health insurance program told Forbes on Thursday. confirmed, bucking the agency’s trend of not providing Medicare coverage. Insurance coverage for weight loss drugs.

important facts

Medicare announced Thursday that Medicare Part D plans offered by private insurers will cover the cost of drugs taken at home, as long as they treat diabetes or reduce the risk of cardiovascular problems in adults with heart disease or obesity. Guidelines have been released to allow the use of weight loss drugs. Or overweight.

Wegovy, an injectable weight-loss drug designated for adults with cardiovascular risk and obesity, falls under the new guidance and could be approved for coverage under Medicare Part D.

The drug is not covered by Medicare members who intend to use it purely for weight loss purposes.

Wegovy’s eligibility under the plan could be the beginning of thousands of prescriptions for adults and billions of dollars in increased spending, the Associated Press reported.

As of March of last year, 51.5 million people were enrolled in Medicare Part D, according to government data.

big number

About $1,200. This is Wegovy’s approximate list price.

Main background

Wegovy was approved by the Food and Drug Administration earlier this month after receiving Priority Review designation from the Food and Drug Administration, making it the first weight-loss drug approved to also help prevent cardiovascular disease. According to the FDA, the approval came after lobbying from lawmakers and drug companies to increase the drug’s availability to Americans, about 70% of whom are obese or overweight. That’s what it means. Novo Nordisk, the sole manufacturer of Wegoby, is seeking to increase access and production of the drug, the Associated Press reported. Novo Nordisk’s stock price has risen more than 76% over the past year and currently trades around $129 per share.

References

Medicare covers Wegovy to reduce heart disease risk (NBC News)

Novo Nordisk’s new obesity drug beats Wegoby in early trials (Forbes)

Medicare paves the way for coverage of obesity drugs (WSJ)

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