Biden to propose expanded Medicare, Medicaid coverage of obesity drugs, official says
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Intense demand for anti-obesity drugs has triggered supply issues, with many turning to cheaper compounded versions sold online.
PHOTO: NYTIMES
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WASHINGTON - US President Joe Biden on Nov 26 proposed expanding coverage of anti-obesity drugs for millions on Medicare and Medicaid, which could cut out-of-pocket expenses for some by as much as 95 per cent.
This would enable more Americans to afford new weight loss medications that can help prevent Type 2 diabetes and lower the risk of death and heart attacks by up to 20 per cent, but cost as much as US$1,000 (S$1,350) a month without insurance coverage.
Current rules for the Medicare and Medicaid government health insurance programmes cover the use of drugs such as Mounjaro, Ozempic and Wegovy for certain conditions like diabetes, but not for obesity as a condition on its own.
A new proposed regulation, to be published by the Department of Health and Human Services on Nov 26, would require Medicare to cover these drugs as a treatment for obesity, expanding access for an estimated 3.4 million Americans with Medicare.
“Medicare coverage would reduce out-of-pocket costs for these prescription drugs by as much as 95 per cent for some enrollees,” the White House said in a statement.
It would also ensure access to the medications for approximately four million adult Medicaid enrollees, it said.
Reuters reported earlier in November that intense demand for anti-obesity drugs has triggered supply issues, with many patients turning to cheaper compounded versions sold online
Mr Biden, a Democrat, has pushed hard to bring down the cost of healthcare and prescription drugs, such as by capping the cost of insulin at US$35 for seniors receiving Medicare, and enacting a US$2,000 cap on out-of-pocket prescription drug costs for the same group.
Mr Biden’s Inflation Reduction Act also required pharmaceutical companies to negotiate drug prices with Medicare, which covers 66 million people. The first price cuts for 10 drugs, ranging from 38 per cent to 79 per cent and starting in 2026, were announced in August.
Healthcare and drug industry groups have filed at least eight lawsuits to block the program, arguing it is unconstitutional and gives too much power to federal regulators.
During his first term in office, President-elect Donald Trump also sought to lower drug prices in a last-minute rule pushed out by his administration in 2020, but the measure was later blocked by a federal judge. REUTERS
