The report estimates the costs of widely popular GLP-1 weight loss drugs from 2026 through 2034, based on an illustrative policy in which Medicare would extend coverage for all beneficiaries with obesity and certain individuals who are overweight. Such a policy would make nearly 13 million older Americans eligible for coverage of the medications.
Four things to know:
- Relative to the total expected costs, the amount of savings realized from patients’ improved health from medications would be small, the report found. It estimated around $50 million in savings in 2026 and up to $1 billion in 2034.
- Over time, the CBO anticipates costs of the drugs will fall, and thus savings achieved from better health outcomes will grow. It expects semaglutide — the active ingredient in Novo Nordisk’s Wegovy, approved to treat weight loss, and Ozempic, approved for diabetes — will be selected by HHS for price negotiations in 2025 “because of its high cost to the Medicare Part D program and duration on the market.”
- The CBO noted that estimates in its reports are “highly uncertain and sensitive to the rapidly evolving, real-world data on use, savings from improved health, prices, eligibility for treatment and other factors associated with the newer class of [anti-obesity medications].
- Many Part D drug benefit plans already cover GLP-1 drugs such as Ozempic and Mounjaro for Type 2 diabetes, though Medicare is prohibited from covering the class of medications when used solely for weight loss. In March, CMS issued guidance stating Part D plans may cover the medications if they are approved for additional health benefits and used specifically for accepted indications, which currently include diabetes and cardiovascular disease.
