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Wegovy to be covered by Medicare for heart disease patients

  • Wegovy was recently approved for lowering the risk of stroke, heart attack
  • Getting your hands on the drug could still be a chore, doctor says
  • Patients are also likely to experience drug shortages

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(NewsNation) — Heart patients insured under Medicare would be covered for Novo Nordisk’s weight-loss drug Wegovy as long as it is prescribed to reduce their risk of heart attacks and strokes, the agency overseeing the program said on Thursday.

Medicare prescription drug plans administered by private insurers, known as Part D, currently cannot cover obesity drugs. Under the new guidance, however, such drugs would be paid for if they receive U.S. approval for a secondary use that Medicare does cover, the U.S. Centers for Medicare and Medicaid Services (CMS) said.

Based on positive results from a large clinical trial, the FDA approved Wegovy earlier this month for lowering the risk of stroke and heart attack in overweight or obese adults who do not have diabetes.

Despite the approval, however, getting your hands on the drug could still be a chore.

“Your doctor is going to have to get a pre-authorization for you. That is not easy, it’s a lot of work with the doctor,” said medical weight loss physician Dr. Sue Decotiis.

Drug shortages will also be difficult to navigate.

“The other issue too, is shortages of these medications,” she said. “Now, we’re talking about shortages of Ozempic and Wegovy and also shortages of Mounjaro, which is the other newer Ozempic. There are shortages of all these medications.”

Reuters contributed to this story.

Health

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