The semaglutide camel’s nose under the Medicare tent

Obesity is a risk factor for cancer, heart disease stroke and diabetes. Thus, drugs like semaglutides (Wegovy, Ozempic) don’t just reduce weight in the obese, they also reduce risk of cancer, heart disease, stroke and diabetes, which are huge health care burdens. It’s good to see that Medicare is finally coming to grips with this obvious fact:

“On March 8, 2024, FDA approved Wegovy (semaglutide) to treat cardiovascular disease risks — heart attack, stroke, and death — for obese or overweight adults with a history of cardiovascular disease, making it the first anti-obesity medication (AOM) to obtain such approval. Studies show that semaglutide reduces heart disease risks when accompanied by blood pressure and cholesterol management and healthy lifestyle counseling.

Less than 2 weeks after FDA approved the new indication (semaglutide is also approved for chronic weight management and type 2 diabetes), CMS issued a memorandum stating that Medicare Part D plans may cover AOMs if they are FDA approved for an additional medically accepted indication beyond only weight management. CMS’ guidance is prospective and is not limited to semaglutide. The guidance applies to all AOMs that may be approved in the future to treat other conditions.”


Notably, FDA’s approval of semaglutide for cardiovascular disease is likely a harbinger of similar approvals in the near future — along with their coverage by Medicare. While the benefits are substantial, so too may be the costs as more and more drugs and patients receive coverage.”

The cost of drugs and vaccines are significant. The reason we’re willing to pay for them is that the costs of the alternatives are greater.

Count me as one who is glad for the success of semaglutides and that Medicare is acknowledging the net benefits of these drugs. Like antibiotics, statins and anti-hypertensives, semaglutides are transformative pharmacy.

Medicare Part D plans may cover anti-obesity meds