Datapoint: Medicare Plans Make Wegovy Coverage Decisions

CVS Health, Elevance Health and Kaiser Permanente said they will cover Novo Nordisk’s weight loss drug Wegovy (semaglutide) for its newly approved cardiac indications, according to a March 28 report in the Wall Street Journal. Wegovy can now be used in obese or overweight patients with cardiovascular disease at risk of cardiovascular death, heart attack and stroke. Medicare does not currently allow Part D plans to cover weight loss therapies, deeming them as cosmetic treatments, but CMS in the wake of Wegovy’s label expansion released guidance allowing plans to cover GLP-1s for cardiovascular indications. CVS’s Aetna currently serves 8.15 million pharmacy lives under the Medicare channel, to Elevance’s 2.11 million. Kaiser, meanwhile, serves 1.84 million Medicare pharmacy lives.

SOURCE: MMIT Analytics, as of 4/1/24

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AIS Health Staff

AIS Health Staff

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