Weight Loss Drug Coverage Could Cost Medicare Billions

The rapid demand for weight loss drugs could stress Medicare significantly. These weight loss drugs are costly. The federal government could be responsible for covering that cost when Medicare recipients seek them out.

The US Congressional Budget Office studied the data. They found it would cost the federal government $35 billion from 2026 to 2034 to cover these drugs. The cost estimate is $1.6 billion for 2026. It would increase to $7.1 billion annually by 2034. The reason?

GLP-1s are highly expensive drugs. The treatments are growing in demand, though. These medications are highly effective at treating obesity. For seniors using Medicare as health coverage, access to GLP-1s could be life-saving. The bill, then? The federal government foots it.

These are “what if” situations. Consider this core concern. About 2/3rd of people receiving Medicare are classified as either overweight or obese. These drugs would could help them lose the weight.

Several factors could reduce this cost. The drugs could become less expensive as new products become available. Numerous companies are working to develop competitive products. Obesity is a costly disease in itself. Data from Novo Nordisk says that the cost of obesity is $1.7 trillion each year in the US. Could weight loss drugs reduce that cost?

Treatment for obesity is a necessary investment. The question is a big one. Can weight loss drugs with high price tags reduce the financial costs of obesity?

Consider the UK

In the UK, weight loss drugs are available to some patients. The NHS, for example, covers Eli Lilly’s weight loss drug. That drug is called Mounjaro in the UK. It could be provided to people considered obese. These individuals must have three weight related health conditions to qualify. This includes conditions such as sleep apnea or high blood pressure.

More research is necessary to understand the cost and benefits of these drugs. With 12.5 million people who could qualify for weight loss drugs as soon as 2026 through Medicare, financial concerns are very concerning. The data from the Budget Office believes about 2% of people receiving Medicare would qualify for these treatments.