Current Market Access to GLP-1s — and What’s Next
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Apr 10, 2025
President Donald Trump’s administration on April 4 abandoned a proposal from Joe Biden’s administration that would have expanded Medicare and Medicaid beneficiaries’ access to obesity drugs, including the popular but costly GLP-1 medications.
Data from MMIT Analytics shows that fewer than 4% of Medicare enrollees have plans that put Wegovy (semaglutide) and Zepbound (tirzepatide) — GLP-1s that were approved for weight loss — under the preferred/preferred (prior authorization and/or step therapy) tier and covered/covered (PA/ST) tiers, as of April 2025 (AIS Health is a division of MMIT.) While Medicare Part D plans are barred by statute from covering weight-loss medications, such plans can cover those when they are approved for other indications, like reducing the risk of stroke or heart attack in patients with obesity.
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