Wegovy Secures Significant Inroad with Access to 3.6 Million Medicare Beneficiaries

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Approximately 3.6 million participants in U.S. Medicare plans could soon benefit from Wegovy, following revelations from a study by the Kaiser Family Foundation. The research indicates that this weight loss medication substantially reduces the risk of strokes and heart attacks among overweight and obese adults who do not suffer from diabetes.

This positive development for Novo Nordisk follows closely on the heels of the FDA's approval last month. The subsequent KFF study pinpointed the number of individuals potentially impacted by the decision. On Wednesday, the Kaiser Family Foundation provided this necessary data, delineating the potential breadth of impact this decision may have.

Wegovy’s newfound applicability stems from a nuanced shift in policy. Under existing regulations, Part D drug plans do not cover medications approved solely for obesity. However, under new guidelines, if a drug also addresses secondary conditions like strokes or heart attacks — conditions that are covered — then coverage is permissible.

The broader implications of this policy shift are yet to unfold, and it remains to be seen whether other pharmaceutical companies will emulate this strategy.

For those keen on tracking developments in weight loss drugs or the regulatory landscape, Cloverleaf AI offers extensive coverage of governmental meetings at local, state, and federal levels. Notably, over the past 90 days, there have been more than 40 meetings, including discussions in the Colorado State Legislature on alternatives to Ozempic and a North Platte City Council meeting in Nebraska regarding University of Texas’s restrictions on Ozempic due to costs. The U.S. House Oversight Committee has also scrutinized whether Ozempic and Wegovy are being marketed to Americans in a manner reminiscent of controversial drugs from the past.

Interested in tracking every government meeting where the inclusion of a new drug in an insurance plan is discussed? Get a demo with Cloverleaf AI.

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