Medicare and Medicaid may soon cover GLP-1 drugs like Ozempic that are being used to treat obesity. But there is no coverage as yet.
Currently, these drugs are paid for by Medicare only when they are prescribed for type 2 diabetes. More than 26 percent of Medicare beneficiaries have type 2 diabetes. GLP-1 medications manage the condition by stimulating insulin release when blood sugar is high and slowing digestion to better control post-meal blood spikes.
The medications work well for diabetes, but they also can cause weight loss. They mimic the hormone which helps control insulin and blood glucose levels, and reduce feelings of hunger, slow digestion, and reduce appetite.
These drugs may also have other potential benefits of lower blood pressure, improving fatty liver disease and reducing risk of heart disease.
Medicare projects that if these new anti-obesity drugs are made available to Medicare and Medicaid beneficiaries, Medicaid spending would increase $14.8 billion over a 10-year period. The drugs are hugely expensive for patients, about $1,000 a month for injections, and patients must use them long term.
If you consider taking these drugs, your doctor will weigh the problems associated with obesity against the side effects of the drugs. Obesity leads to Type 2 diabetes, muscular-skeletal problems, cancers, high blood pressure, heart disease and more. The GLP-1 drugs can cause inflammation of the pancreas, gastrointestinal issues, and hypoglycemia, among other things.
If you start taking one of these drugs (usually once-a-week by injection), you might have to continue taking them for many months. If you stop, you may gain weight again, if you haven't changed your diet and exercise habits. Also, the drugs may stop being effective for weight loss over time.
