Millions of Americans with obesity could soon gain access to popular weight-loss drugs including Wegovy and Ozempic through Medicare and Medicaid under a new proposal from the Biden administration.
Announced Tuesday by the Department of Health and Human Services (HHS), the rule aims to make these costly medications available to a broader population, sparking a contentious debate about its potential affect.
The drugs, heralded by some as miracle treatments, help patients lose 15 to 25 percent of their body weight by mimicking hormones that regulate appetite.
However, with monthly costs reaching $1,000 to $1,300, affordability remains a significant barrier. "It's a good day for anyone who suffers from obesity," said HHS Secretary Xavier Becerra. "It's a game changer for Americans who can't afford these drugs otherwise."
Costly Proposal Faces Opposition
The proposal, which could cost taxpayers up to $35 billion over the next decade, sets the stage for a clash between the pharmaceutical industry and Robert F. Kennedy Jr., President-elect Donald Trump's nominee for HHS Secretary.
Kennedy has voiced strong opposition to government-funded coverage of weight-loss drugs, advocating instead for investment in healthy food and gym memberships.
"For half the price of Ozempic, we could purchase regeneratively raised, organic food for every American, three meals a day and a gym membership, for every obese American," Kennedy said during a federal lawmakers' roundtable earlier this year.
The rule would not be finalized until January, just days after Trump takes office. While the President-elect has not publicly addressed the issue, his allies and Cabinet picks have signaled plans to reduce government spending, potentially jeopardizing the measure.
Millions Could Benefit
Under the proposal, individuals with a body mass index (BMI) of 30 or higher would qualify for coverage.
While some patients with diabetes or other chronic conditions already receive coverage for these drugs, Becerra estimated that an additional 3.5 million Medicare recipients and four million Medicaid beneficiaries would be eligible.
Research suggests the actual number of qualifying individuals could be far higher, with an estimated 28 million Medicaid enrollees classified as obese. The rule would also reverse a decades-old rule preventing Medicare from covering weight-loss drugs by officially recognizing obesity as a treatable disease.
High Costs and Limited Supply
The antiobesity drug market has grown significantly with the introduction of weekly injectables including Wegovy and Eli Lilly's Zepbound. However, their high costs and supply shortages have limited accessibility, making it largely more available to wealthier individuals, including celebrities who tout their effectiveness.
As the debate unfolds, the Biden administration's push for expanded access highlights the broader struggle to balance health care affordability with budgetary constraints.
This article includes reporting from The Associated Press
English (US) ·