The U.S. Medicare announced that it would cover the weight-loss drug Wegovy, manufactured by Novo Nordisk (NVO), for patients suffering from cardiovascular disease.
The announcement comes after the U.S. Food and Drug Administration recently approved the weight-loss drug to use for reducing heart risk. The FDA’s decision was based on a clinical trial last year which found that Wegovy reduces risk of heart disease in obese patients by 20 percent.
Earlier, federal law had excluded anti-obesity medications from medicare prescription drug plans provided by private insurers, also known as Part D. The high cost of the drug was also another reason which made insurers reluctant to cover it.
However, the recent announcement broadens the insurance coverage of Wegovy, a drug mimicking a naturally occurring hormone called glucagon-like peptide 1, or GLP-1, that slows the emptying of the stomach and sends a signal of fullness to the brain.
The Centers for Medicare and Medicaid Services or CMS noted that the weight loss drug will be covered under insurance only for cases where it is prescribed to reduce the risks of heart disease.
“CMS has issued guidance to Medicare Part D plans stating that anti-obesity medications that receive FDA approval for an additional medically accepted indication can be considered a Part D drug for that specific use,” a CMS spokesperson commented.
“CMS is committed to ensuring that people have access to treatments and treatment options that improve health outcomes,” the agency emphasized.
Novo Nordisk responded to the announcement positively by saying that, “We are encouraged to see the recent guidance by CMS,” but further added that “there’s more work to be done” because Wegovy as a weight-loss drug is still not covered under insurance.
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