Fortune | FORTUNE 11月07日 03:05
Medicare拟扩大减重药物覆盖,降低药费
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特朗普政府宣布了一项旨在扩大Medicare覆盖范围以包括某些减肥药物的里程碑式协议,此举可能会极大地改变数百万老年人获得这些治疗的机会。根据白宫的官方声明,特朗普政府已与包括Ozempic和Wegovy在内的流行减肥药物的制造商礼来和诺和诺德达成协议,以降低成本并允许从2026年开始扩大Medicare的覆盖范围。通过TrumpRx.gov网站购买,Ozempic和Wegovy的价格将从每月1000美元和1350美元降至350美元。其他产品,包括即将上市的药丸,通过Medicare和Medicaid的购买价格低至每月145美元。尽管此前Medicare在法律上被禁止覆盖专门用于减肥的药物,但由于Wegovy等药物新用途的FDA批准,特别是用于降低超重人群心血管疾病的风险,为更广泛的Medicare覆盖打开了大门。然而,仅针对减肥的Medicare覆盖仍然滞后。国会预算办公室估计,通过Medicare覆盖这些抗肥胖药物可能会在2026年至2034年间增加至少350亿美元的联邦支出。

🤝 特朗普政府宣布与制药公司达成协议,旨在扩大Medicare对特定减肥药物的覆盖范围,预计从2026年开始实施。

💰 GLP-1药物(包括Ozempic和Wegovy)的价格将大幅降低,通过TrumpRx.gov网站购买,价格将降至每月350美元,其他药物价格更低。

📜 此前,Medicare受到法律限制,禁止覆盖专门用于减肥的药物,但由于部分减肥药物被批准用于治疗其他疾病,Medicare的覆盖范围开始有所松动。

💸 国会预算办公室估计,新的覆盖政策可能导致联邦支出在2026年至2034年间增加至少350亿美元,但药品竞争和进一步谈判可能会降低实际成本。

📊 美国疾控中心数据显示,约40%的美国成年人患有肥胖症,60岁及以上人群的肥胖率接近39%,减肥药物的影响可能已导致部分州的肥胖率出现首次下降。

President Donald Trump has announced a landmark deal aiming to expand Medicare coverage to include certain weight-loss medications, a move that could dramatically change access to these treatments for millions of older Americans. On November 6, Trump revealed that his administration had struck agreements with Eli Lilly and Novo Nordisk, the makers of popular weight-loss drugs including Ozempic and Wegovy, to reduce costs and allow for broader Medicare coverage starting in 2026.

Under the arrangement, prices for GLP-1 drugs—used both for diabetes and obesity—will be slashed for Medicare and Medicaid beneficiaries. The prices of Ozempic and Wegovy will fall from $1,000 and $1,350 per month, respectively, to $350 when purchased through through the TrumpRx.gov website set to launch in January 2026, according to the White House’s official communication. Other products, including upcoming pills, will be available for as little as $145 per month through Medicare and Medicaid, according to a background press briefing reported by CNBC.

​“We’re going to be paying, instead of $1,300, you’ll be paying about $150,” Trump said in mid-October while highlighting a separate drug price deal. At the time, Centers for Medicare and Medicaid Services administrator Mehmet Oz clarified that that negotiations were still ongoing.

Current Restrictions and Changing Policies

Until now, Medicare had been prohibited by law from covering medications prescribed specifically for weight reduction, a policy rooted in the 2003 Medicare Modernization Act, as noted by health news service KFF. Recent FDA approvals of new uses for drugs like Wegovy, especially for reducing the risk of heart attacks and strokes in overweight individuals with cardiovascular disease, have started to open the door for broader Medicare coverage. The Centers for Medicare & Medicaid Services (CMS) recently signaled that Part D plans can now add some of these drugs to their formularies, provided they have a medically accepted use that isn’t specifically excluded.

Despite these changes, actual Medicare coverage for weight loss alone—as opposed to additional conditions like diabetes or heart disease—has lagged behind, mainly due to longstanding federal restrictions and concerns over potential costs to the system.

Costs and Fiscal Concerns

The fiscal implications of the new coverage policy are significant. The Congressional Budget Office (CBO) has estimated that covering these anti-obesity drugs through Medicare could increase federal spending by at least $35 billion from 2026 through 2034, with average costs per user around $5,600 in 2026, though competition and negotiations could drive these numbers lower over time. The national debt topped $38 trillion just weeks ago, with budget watchdogs at the Committee for a Responsible Federal Budget and the Peter G. Petersen Foundation decrying the runaway, escalating nature of America’s insolvency. ​

Obesity affects about 40% of U.S. adults, according to the Centers for Disease Control and Prevention (CDC), and nearly 39% of Americans age 60 and older are affected, although obesity rates have started falling in many states for the first time in a decade, likely due to weight-loss medication’s impact. ​

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Medicare Weight-Loss Drugs Drug Pricing Healthcare Policy Obesity
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