CNN
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Medicare shelled out $5.7 billion on Ozempic and different related diabetes medicine in 2022, up from $57 million in 2018, in keeping with a brand new KFF evaluation.
The expensive drugs, which embrace Mounjaro and Rybelsus, have turn out to be tremendous widespread for the therapy of diabetes and for weight reduction. However Medicare isn’t allowed by regulation to cowl medicine for weight reduction.
Medicare started masking Ozempic for folks with diabetes in 2018, with Rybelsus and Mounjaro becoming a member of in 2019 and 2022, respectively. Medicare lately introduced that it will cowl Wegovy in people who find themselves overweight or obese and have heart disease after the drug gained approval from the US Meals and Drug Administration for cardiovascular advantages.
The KFF research examined gross spending, which doesn’t keep in mind any rebates paid by drug producers that will decrease Medicare spending. Information on rebates isn’t publicly out there.
Ozempic ranked because the sixth prime promoting treatment in Medicare Half D drug plans in 2022, up from tenth the prior 12 months, in keeping with KFF. Medicare spent $4.6 billion on it in 2022, in contrast with $2.6 billion the 12 months earlier than. The present list price for Ozempic is $969 for a four-week provide.
The medicine’ reputation and costs might find yourself elevating prices for each the federal authorities and Medicare enrollees broadly.
“These medicine supply substantial potential well being advantages, however the mixture of intense demand, new makes use of, and excessive costs for these remedies is prone to place great strain on Medicare spending, Half D plan prices, and premiums for Half D protection,” KFF wrote in its evaluation.
Though protection of Wegovy and related medicine might scale back different well being care spending, these drugs at their present costs would in all probability nonetheless price the federal authorities greater than they might save, in keeping with a Congressional Finances Workplace evaluation launched final week.
Medicare might select Ozempic and Rybelsus for its drug negotiation program as early as 2025, KFF wrote, which might decrease spending on the drugs.