Certain Medicare patients may get help paying for the popular weight-loss drug Wegovy, as long as they also have heart disease.
FILE - Donna Cooper holds up a dosage of Wegovy, a drug used for weight loss, at her home, March 1, 2024, in Front Royal, Va. The popular weight-loss drug Wegovy may be paid for by Medicare as long as patients using it also have heart disease and need to reduce the risk of future heart attacks, strokes and other serious problems, federal officials said Thursday, March 21.
In practice, the guidance opens the door to wider coverage of Wegovy, the brand name of Novo Nordisk’s obesity medication semaglutide. The U.S. Food and Drug Administration this monththat allows Wegovy to be used to reduce the risk of cardiovascular events in people who are overweight or have obesity and also have existing heart disease.showed that Wegovy cut the risk of heart attack, stroke and other problems by 20% versus a placebo, or dummy drug, in such patients.
Even if plans do allow coverage, people who meet the criteria may still face other restrictions. Plans may require higher out-of-pocket fees, prior authorizations or step therapy, in which a patient is required to try a lower-cost drug before proceeding to the new treatment, Neuman said.
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