Pharmacies have been seeing compelling interest in Medicare’s GLP-1 Bridge program since its July launch, NPR first reported.
The demonstration, designed to give eligible Medicare Part D beneficiaries access to certain GLP-1s at a fixed monthly cost, will run through 2027. Manufacturers are supplying GLP-1s at a monthly net price of $245, and beneficiaries cover $50. Unlike the proposed voluntary “Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth” — or BALANCE — model pilot, Bridge bypasses Part D sponsors.
However, for BALANCE, sponsor participation needed to hit a certain threshold. CMS ultimately paused BALANCE for Part D indefinitely, while extending Bridge. As Bridge kicked off, a CMS official said the agency planned to share more about Bridge insights with Part D sponsors. CMS said it would review its 18 months of data to inform whether Bridge should continue past 2027.
Becker’s connected with Walgreens and CVS Health to unpack how Bridge has been progressing so far. To date, each company has filled more than 100,000 GLP-1 prescriptions through the program.
“We have seen actually uptake be pretty strong in the first part of the program,” Rick Gates, chief pharmacy officer for Walgreens, told Becker’s. “… I would say it is far exceeding from a volume perspective what we expected at this point.”
Mr. Gates said Bridge is continuing to grow. When asked about expectations for 2027, he said the program could still hit a ceiling with participation, though.
“I think you will get to a natural run rate of patients that stay on — that get on these therapies, stay on these therapies — and some will transition off and then look for other ways to make sure they’re maintaining weight,” he said. “I don’t know that you’re going to see this continue to skyrocket, if you will. But I think there’s going to be a natural plateau where it does kind of hit a ceiling point.”
The program is unique in that the GLP-1 prescriptions run for 30 days, he added, giving Walgreens more opportunities to guide patients through side effects and “lean in as pharmacists and do adherence programs, do follow-up calls, do the appropriate things to make sure that they get on therapy and stay on therapy.”
Bridge outlines clinical criteria for eligibility, but CVS emphasized its acceptance of prescription discount cards, as well as manufacturer coupons and vouchers, for other patients. The company also partnered with Novo Nordisk for discounted Wegovy and Ozempic, saying it was “the first to build a streamlined NovoCare enrollment experience.”
While CVS said its pharmacy benefit manager, Caremark, has been updating its commercial formularies to expand GLP-1 options, Walgreens’ Mr. Gates said Bridge’s separation from health insurers’ independent criteria — such as for prior authorization — makes the process more direct.
“I think there is a simplicity to it for physicians and for patients that they understand exactly what the criteria is, and once you qualify there, you’re going to get coverage,” he said.
With lingering uncertainty about Bridge’s future, and whether BALANCE could ever come to fruition, Mr. Gates said Part D sponsors have not yet asked Walgreens about Bridge takeaways.
“We haven’t really been in big talks about uptake or any of that with any of the health plans,” he said.
Mr. Gates warned “the biggest watch-out” could be whether beneficiaries have coverage after the 18 months.
“Then you have a bunch of individuals that are on weight-loss medications, and what’s that look like after that?” he said.
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