Will GLP-1–Receptor Agonists Break the (Medicare) Bank?

Glucagon-like peptide-1 (GLP-1)–receptor agonists are covered by U.S. Medicare Part D (the prescription drug benefit) for managing diabetes associated with overweight or obesity but federal law prohibits coverage for weight loss alone. However, after a recent trial showed fewer adverse cardiovascular events with an injectable GLP-1 agonist (semaglutide, brand name Wegovy) than with placebo (NEJM JW Gen Med Dec 15 2023 and N Engl J Med 2023; 389:2221), Medicare announced it would cover this semaglutide formulation for patients with body-mass index (BMI) ≥27 kg/m² and established cardiovascular disease (CVD). In this study, Investigators abstracted survey data from a nationally representative group of ≈5000 patients aged ≥65. The investigator…