Medicare

Medicare coverage for weight loss drugs: The push to expand availability for older Americans

Novo Nordisk, the maker of the weight loss drug Ozempic, is lobbying to push regulators to include the drug under Medicare coverage.

Arnold & Porter Kaye Scholer LLP, a law and lobbying firm, was hired last month, according to official lobbying registration forms, by the pharmaceutical company to pressure policymakers and members of Congress to cover weight-loss treatments under Medicare.

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Ozempic is covered under Medicare Part D to treat type 2 diabetes, and without coverage, the drug can cost around $16,000 for patients. Medicare Part D are private insurance plans, and the cost of prescription drugs under Part D varies depending on the users insurance.

Lobbyists are pushing that by only providing coverage under Medicare Part D, senior citizens are being excluded. Senior Americans generally qualify for Medicare Part A and Part B at 65 years old. Over 40% of Americans over the age of 60 are overweight, according to the Centers for Disease Control and Prevention.

While Ozempic is approved by the Food and Drug Administration to treat type 2 diabetes in adults, the drug has not been cleared for weight loss. However, another Novo Nordisk product, Wegovy, is the only new drug with FDA approval to treat obesity.

Eli Lilly, another major American pharmaceutical company, has hired a number of firms to lobby for the type 2 diabetes medication Mounjaro to treat weight loss, starting their effort in 2021. In January, Eli Lilly hired the Todd Strategy Group to lobby for the potential coverage of Mounjaro under Medicare, according to official records.

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Ozempic is a once-a-week injection that can help people lose about 12% of body mass on average, according to a study conducted by medical researchers published by the National Library of Medicine. While the drug is shown to be safe and effective in clinical trials, Ozempic can not legally be prescribed to treat weight loss.

Last year, Novo Nordisk spent $4.6 million on lobbying efforts for the federal government, and the company has spent $1.3 in the first three months of 2023, according to records.