Medicare has officially extended its coverage to Wegovy for patients at risk of heart disease.
Enrollees in Part D plans will now have access to a popular weight-loss drug when it is specifically prescribed as a treatment to prevent strokes and heart attacks, according to the Centers for Medicare and Medicaid Services (CMS).
According to NPR, Wegovy is categorized as a GLP-1 agonist, meaning it relies on hormones and the brain to reduce one’s appetite.
Medicare, which provides coverage for more than 65 million people in the US, according to data from CMS, was previously prohibited from covering any form of weight loss medication. However, a recent decision by the Food and Drug Administration expanded the approval to allow Wegovy to be prescribed only if the patient is overweight, to reduce the risk of heart disease.
Stethoscope.
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Their decision came after a 2023 clinical trial showed the drug reduced the risk of heart problems for overweight people by 20 percent, according to The Washington Post.
The same decision to allow Wego coverage also applies to state Medicaid plans. However, at the time of writing, Medicare will not cover the drug if it is used solely for weight control.
CMS said in a statement to NPR that they are “committed to ensuring that people have access to treatments and treatment options that improve health outcomes.”
The stars who spoke about Ozempic — and what they said
Wegovy, like the related semaglutide drug Ozempic, has become popular among celebrities for weight loss. Oprah Winfrey, Keke Palmer, Amy Schumer and others have spoken about its recent expansion in Hollywood and beyond.
Ania Jastreboff, MD, told PEOPLE in January, “The most common side effects of these drugs are nausea and diarrhea, and sometimes you may experience vomiting or constipation.”
Jatreboff also noted, “If the drug is increased too quickly, these side effects are more likely to occur.”
Medicare’s acceptance of new drugs for coverage usually comes first before private insurance companies start paying. It remains to be seen when and if others will follow Medicare’s lead and offer coverage options for Wegovy.
Categories: Trends
Source: HIS Education