Medicare coverage of Novo Nordisk’s Wegovy could cost up to $145B annually

Novo Nordisk’s (NVO) weight reduction drug Wegovy (semaglutide), which could be prescribed to Medicare beneficiaries who’re each overweight and have heart problems, could cost the system up to $145B per 12 months.

If all beneficiaries who’re eligible for Wegovy have been to obtain it, it will cost Medicare $34B to $145B annually, relying on the definition of established CVD, in accordance to a report within the Annals of Internal Medicine.

In March, the U.S. FDA accredited a further indication for Wegovy for discount of main CV occasions resembling coronary heart assault, stroke and demise in obese or overweight folks with established CVD. This indication made the drug eligible for Medicare coverage for these with heart-related illnesses.

The $34B determine relies on 3.6M enrollees changing into eligible for Wegovy coverage, whereas $145B is that if 15.2M are eligible, based mostly on a extra liberal definition of CVD.

A Kaiser Family Foundation research launched in April discovered that 3.6M Medicare sufferers could qualify for Wegovy coverage.

Eli Lilly’s (LLY) rival Zepbound (tirzepatide) doesn’t but have a CVD indication although the corporate is pursuing it. Data from the part 3 SUMMIT trial launched earlier in August discovered the drug minimize the chance of coronary heart failure by 38% in contrast to placebo.