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Unpacking Medicare and the Ground-Breaking Step into Weight-Loss Drugs

health

By Owen M.

- Mar 25, 2024

Here's a health fact for you - Wegovy (semaglutide) will now be covered by Medicare. This comes as a game-changer for those plagued by obesity, an increased risk of heart attacks, strokes or other life-threatening cardiovascular problems. Giving conventional wisdom a good twist, this marks a prime departure from Medicare's long-standing rule of not covering weight loss drugs (yeah, seriously!).

The man responsible for throwing this spanner in the works? The U.S. Food and Drug Administration (FDA). The recent approval of Wegovy in preventing strokes and heart attacks seemed enough of a nudge for Medicare to include it in its Part D prescription drug plans.

However, don't let this progress fool you entirely. The coverage isn't for all anti-obesity medicines and still only applies to heart disease-afflicted individuals, who stand to benefit from shedding a significant amount of weight.

Wegovy currently has the unique distinction of being the only weight loss drug on the FDA's special approval list. Clinical trials published in the New England Journal of Medicine showed that Wegovy diminished risk of crippling conditions such as strokes or heart attacks and even associated mortality by 20 percent.

Leaning on these trials, Melanie Jay, MD, an associate professor and director of obesity research at NYU Grossman School of Medicine, attributes the long-awaited recognition of obesity as a bona fide disease as a major contributor to FDA's approval and Medicare's coverage of Wegovy.

Though Medicare's horizon, for now, doesn't extend to drugs like Zepbound, Qsymia, or Contrave, the recent break in its otherwise unsupportive stance towards weight loss drugs, brings a sigh of relief for many struggling with obesity.

But, also thanks to Wegovy, we now have a new predicament: an alarming shortage of the drug, particularly at starting doses. This might give Medicare patients a tough time accessing the lifesaver they badly need.

Fear not, however, the silver lining to this cloud is private insurers. This precedent set by Medicare can push them to cover Wegovy and benefit millions of Americans in their workforce.

Just remember, the drug isn't without some possible side effects like sarcopenia - an accelerated loss of muscle mass common among the elderly. Balancing the Wegovy regimen with adequate resistance training can keep this under check.

It seems the competitive, pun-riddled, and wild world of healthcare is finally embracing the new age of weight loss drugs and sustainable health solutions. Eat your kale, but remember, it's not all green sauce and salad; sometimes it's about taking drastic, groundbreaking steps to revolutionize healthcare!

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