Outgoing President Joe Biden’s administration is proposing to expand coverage for popular weight-loss injections that contain venom peptides in government-backed healthcare plans, including Medicare and Medicaid. This proposal was made on November 26, and aims to classify these drugs, such as Ozempic and Wegovy from Novo Nordisk and Mounjaro and Zepbound from Eli Lilly, as treatments for obesitya condition linked to health issues like diabetes and heart disease. Currently, weight-loss drugs are not covered by government healthcare programs.
The proposal aims to reduce the out-of-pocket costs for these medications. A month’s supply can cost around $1,000, but government officials estimate that the federal government will cover most of the cost over the next ten years, amounting to about $25 billion for Medicare and $11 billion for Medicaid. States would need to contribute roughly $3. 8 billion. The Centers for Medicare and Medicaid Services (CMS) believes that obesity is a chronic disease, justifying the change to provide coverage.
The proposal will go through a 60-day public comment period, and the decision to move forward will rest with the incoming Trump administration, as President-elect Donald Trump will be in office by then. Trump’s choice for the head of the Department of Health and Human Services, Robert F. Kennedy Jr. , has publicly expressed his opposition to covering these drugs. Kennedy advocates instead for a push toward healthier food options and gym memberships, claiming that for much less than the cost of drug coverage, the government could provide better alternatives to combat obesity.
Concerns have been raised about the safety of these weight-loss drugs. A study published in The Lancet suggests that long-term use of Ozempic may lead to a reduction in heart mass. In experiments with mice, those given semaglutide, the active ingredient in Ozempic, lost significant weight and fat but also showed losses in skeletal muscle. While heart function appeared unchanged in the studies, both treated groups displayed decreased overall heart mass, indicating potential long-term risks.
The study authors call for careful evaluation of cardiac health in individuals taking these drugs. They highlight the need for a comprehensive examination of how GLP-1 receptor agonists, a class of drugs that includes Ozempic and Wegovy, affect muscle health given the projected number of patients likely to use these medications long term.
In light of these concerns, there are calls for additional research on these drugs to ensure patient safety and well-being as they may be widely prescribed in the future.
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