About 3.6 million Medicare enrollees may qualify for coverage of the anti-obesity drug Wegovy.
About 3.6 million Medicare enrollees may qualify for coverage of the anti-obesity drug Wegovy , according to a KFF analysis released Wednesday. But it could wind up costing Medicare nearly $3 billion a year and contribute to higher Part D premiums for all beneficiaries. Medicare announced last month that Part D drug plans could start covering Wegovy for beneficiaries who are overweight or obese and have a history of heart disease after the U.S.
Just how many beneficiaries start taking Wegovy depends on several factors, including how many insurers add it to their Part D formularies. CVS Health’s Aetna and several other insurers have said they will do so, although they may add restrictions, such as prior authorization.Also, Wegovy’s hefty price may be a hurdle for some enrollees, who could face monthly co-insurance costs of $325 to $430 before they reach the new cap on out-of-pocket drug spending, KFF said.
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