I'm an independent healthcare analyst with more than 25 years of experience analyzing, publishing and presenting/educating on healthcare policy and pharmaceuticals. I have 114 publications in peer-reviewed journals, in addition to more than 450 articles in periodicals and newspapers. I have also presented my work at numerous conferences.
The weight loss drug Wegovy secured a supplemental cardiovascular indication from the Food and Drug Administration last month. This allows forHowever, because a cardiovascular indication to prevent heart attacks or strokes was added last month to an already approved obesity drug, Wegovy , this paves the way for coverage by health plans operating in the Medicare Part D program. These plans may now cover Wegovy for patients who are overweight or obese and have preexisting cardiovascular disease.
Furthermore, going forward Medicaid plans will be obligated to place Wegovy on their lists of drugs which they reimburse. But state Medicaid agencies and managed care plans can still require patients to undergo step edits before they can obtain Wegovy for the cardiovascular indication. This means they may have to try cheaper alternatives before being able to access the product.in which all medicines must be reimbursed.
Restrictions are also probable because the absolute risk reduction of 1.5% of significant cardiovascular events among SELECT trial participants was relatively small. Namely, during the SELECT trial major adverse cardiac events occurred in 6.5% of patients on Wegovy and 8% of those on placebo. This translates into a number needed to treat of 67 to avoid one severe cardiovascular event, which may not be considered a particularly good value proposition from an insurer’s perspective.
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