While Medicare is not allowed under existing law to cover the drugs for weight loss, Medicare Part D plans can cover them for other medically accepted indications, such as reducing cardiovascular risk, according to a recent CMS memo.
Medicare Part D authorized use coverage of GLP-1 drugs could point to higher spending, especially as policymakers look at legislation that would allow Medicare to cover obesity drugs.
While the drugs offer possible health benefits, strong demand, new usage, and high treatment prices could put pressure on Medicare spending, Part D plan costs and Part D coverage premiums. The ranking below shows where weight loss medications rank among all drugs by total Medicare Part D gross spending before rebates.
Drugs ranked by total Medicare Part D gross spending before rebates in 2022:
*rebates result in lower gross spending.
- Eliquis: $15.2 billion
- Trulicity: $6.2 billion
- Revlimid: $5.9 billion
- Jardiance: $5.9 billion
- Xarelto: $5.8 billion
- Ozempic: $4.6 billion
- Januvia: $4.1 billion
- Humira pen: $3.7 billion
- Trelegy Ellipta: $3.3 billion
- Lantus Solostar: $2.9 billion
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