According to a report in the Washington Post a five-year pilot program that would allow weight-loss drugs through the federal
Medicare and Medicaid health insurance programs. The newspaper reports this, citing documents from the Centers for Medicare and Medicaid Services (CMS).
Under the plans, these programs would cover drugs such as Wegovy and Ozempic from Novo Nordisk and Zepbound and Mounjaro from Eli Lilly for weight reduction.
These drugs have been shown in studies to reduce body weight by 15-20 % can reduce body weight. However, the costs are 5,000 to 7,000 US dollars per yearwhich raises questions about long-term affordability for states and the government.
The initiative would mark a turnaround in US healthcare policy after the Trump administration rejected a Biden-era proposal to cover the cost of weight loss drugs earlier this year.
According to Washington Post currently 13 states currently cover the cost of such drugs for Medicaid patientswhile Medicare coverage exclusively for weight loss so far excludesbut it is covered for other approved indications such as sleep apnea or heart disease permitted.
The planned CMS pilot program provides for a Medicaid test run in April 2026 and a Medicare test run in January 2027 will start.
A spokesperson for Novo did not want to comment directly on the pilot project, but emphasized that "comprehensive coverage by public and private insurance is crucial for affordable healthcare and treatment options".
CMS itself stated that it would not comment on possible new care models.
Background:
Over 70 million people are covered by Medicaid (for low-income people), while around 65 million people Medicare (for seniors and people with disabilities).
Following the announcement of the plans, the Eli Lilly shares rose by almost 2% in pre-market tradingthe US-listed shares of Novo Nordisk rose by 2,6 % . European pharmaceutical companies on the other hand, suffered price losses on Friday morning.
The analyst Courtney Breen from Bernstein views the development positively for Eli Lilly and expects significant benefits for the company, especially after the launch of its experimental oral weight loss drugwhich, according to the Washington Post should also become part of the pilot program - if it receives approval.
Both Lilly and Novo Nordisk are investing heavily to meet the growing demand. Novo Nordisk has invested 4.1 billion US dollars for the expansion of its US production capacities.
Eli Lilly did not initially respond to a Reuters request for comment.
