A combined image shows an injection pen for Eli Lilly and Co’s diet drug Zepbound and a box of Wegovy, made by Novo Nordisk.
Reuters
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Good afternoon and happy Tuesday! Not surprisingly, expanding Medicare coverage of expensive weight-loss drugs could come at a steep cost to the federal government.
Allowing Medicare to cover obesity drugs would increase federal spending by about $35 billion from 2026 to 2034, according to one study. analyze The Congressional Budget Office announced last week.
CBO said the federal cost to pay for these drugs will increase from $1.6 billion in 2026 to $7.1 billion in 2034.
The analysis is entirely hypothetical and comes as drugmakers and advocacy groups urge the government to expand coverage of the popular treatment and make it available to more seniors. These include GLP-1 to treat obesity, such as Novo NordiskWego peacekeeping Eli Lilly and CompanyZepbound, both products come with a hefty price tag, about $1,000 per month before insurance and other rebates.
Currently, Medicare does not cover weight loss treatments unless they are approved and used to treat other health conditions. For example, Medicare covers Wegovy to reduce the risk of serious cardiovascular complications in patients with heart disease and obesity, but not the weight-loss drug.
The Congressional Budget Office estimates that savings will be achieved by improving patient health, primarily by reducing the incidence of obesity-related diseases.
Will grow over time. However, the company said those savings are likely to be relatively small, totaling less than $50 million by 2026 and reaching about $1 billion by 2034.
“While net federal savings per user are expected to be larger over the long term, they remain below drug costs,” the Congressional Budget Office said in the report.
Drug costs are also likely to decline over time, the Congressional Budget Office said.
Here’s why: It expects generic versions of popular weight-loss injections to hit the market and lower prices. CBO also expects the average net price of obesity drugs to decline in 2027 as a result of Medicare drug price negotiations with manufacturers.
Semaglutide, the active ingredient in Wegovy and Novo Nordisk’s diabetes drug Ozempic, could be one of 15 prescription drugs subject to the next round of price negotiations, which are due to begin in 2025 and take effect in 2027.
But how does Medicare coverage of these treatments affect access to care?
If Medicare covers the drugs, more than 12.5 million beneficiaries will be newly eligible for weight-loss drugs starting in 2026, according to CBO. About 2% of these patients are expected to use these treatments in the first year, the analysis said.
More than two-thirds of Medicare beneficiaries
Classified as obese or overweight based on their physical condition
According to the Congressional Budget Office, body mass index.
It’s worth noting that payouts may look slightly different after 2034.
Medicare spending on weight-loss drugs is likely to decrease on a per-user basis due to lower costs and higher savings associated with the drugs, the Congressional Budget Office said. But Medicare coverage of these treatments will still increase net federal costs from 2034 to 2044, the Congressional Budget Office noted.
A Novo Nordisk spokesman said in a statement on Tuesday that the medical and social costs of obesity are “enormous,” with some estimates costing the U.S. more than $1.7 trillion annually.
“We know that obesity treatments are associated with better medical outcomes, even if officials haven’t figured out how to account for these savings,” the spokesman said, adding that the company hopes Medicare will start covering the weight-loss drugs.
Eli Lilly did not immediately respond to CNBC’s request for comment.
Please feel free to send Annika any tips, suggestions, story ideas and data: annikakim.constantino@nbcuni.com.
The latest in healthcare technology: CNBC tests Abbott’s continuous glucose monitor Lingo
Stacey Westcott | Chicago Tribune | Tribune News Service | Getty Images
I’ve been testing Abbott LaboratoriesIn the past few weeks, consumer-friendly continuous glucose monitors have emerged, a neat new tool for those who want to gain insight into how their metabolism works.
The device, called Lingo, is a small sensor that pierces the skin to measure immediate blood sugar levels. It’s very comfortable and easy to use. I wear it on the back of my right arm, but most of the time I forget it’s there.
I’ve tried continuous glucose monitors before, but this was my first time testing Abbott’s continuous glucose monitor. The company launched Lingo in September, followed by rival Dexcom’s launch of its own consumer-oriented display, Stelo, in late August. Before Stelo was released, I did commentary for CNBC.
There are many similarities between Lingo and Stelo, but Abbott’s app gives a more comprehensive look at your blood sugar data over time than Dexcom’s. If you’re interested in exploring your metabolism on a more granular level, Abbott’s system may be a better product for you.
Glucose is a sugar molecule that comes from food and is our body’s main source of energy. Everyone’s blood sugar levels are different, but if blood sugar levels are consistently high, people may develop serious health problems such as metabolic disease, insulin resistance, and heart disease. Abbott said Lingo is designed to help educate users about their habits and teach them to manage their blood sugar in a healthier way.
Historically, continuous glucose monitors have been prescribed for people with diabetes, but Lingo is for adults like me who don’t have diabetes. It’s available without a prescription, so you can buy the sensors online for $49 out of pocket, $89 for two sensors or $249 for six.
Dexcom’s Stelo is also available over the counter, with an ongoing subscription costing $89 per month for two sensors. Stelo sensors last up to 15 days before needing replacement, and Lingo sensors last up to 14 days.
Once your Lingo sensors arrive, it’s easy to start using them. I downloaded the Lingo app, entered some basic biometric information, and prepared to apply the sensor to my arm. The app guides you through every step and is easy to follow.
I started by assembling my applicator, which inserts the sensor into the upper arm. There’s a needle in the applicator, but a flexible filament ends up under the skin underneath the sensor itself.
I don’t usually get nervous around needles, but I had to get myself excited to use Lingo. You have to press the applicator firmly against the back of your arm, so it was a little intimidating for me to do it myself. To apply Stelo using Dexcom’s applicator, I just click a button.
I finally worked up the courage to step on the sensor, which was really nothing to be nervous about. I did feel some pain but it went away after about 10 minutes. When my 14 days were over and it was time to replace the sensor, I felt much more comfortable the second time around.
Lingo is really easy to wear. I don’t notice the sensor while sleeping and I can wear all of my normal clothes. I just recommend being careful when wearing long sleeves so you don’t get snagged. To remove the sensor, you can peel it off like a Band-Aid.
The sensor takes an hour to warm up and then begins transmitting your real-time blood glucose levels to the Lingo app. One of Abbott’s main goals is to help users understand blood sugar spikes, which is where the app really shines.
Blood sugar spikes occur when the amount of sugar in the blood increases quickly and then decreases. They usually occur after eating, but can also be caused by stress, exercise, and other factors. Limiting spikes and improving blood sugar management can help users improve sleep and mood, manage weight and be proactive about their future health, Abbott said.
To help users conceptualize the impact of spikes, the company created a metric called “Lingo Count.” This is an algorithm that assigns each glucose spike a numerical value, which is supposed to represent the severity of the impact.
Each day, users have a target term count they want to keep below that target, and it adjusts to your body over time. My Lingo Count goal was originally 60 and is now 44.
This is a very useful way to conceptualize the effects of diet on the body. For example, when I ate a Greek vanilla yogurt, my verbal count increased by 5 points, and when I ate a few pieces of candy, it increased by 14 points. Healthy habits in my mind. I didn’t manage to fall below my goal every day, but I did have a better understanding of why this was happening and what I could do about it.
I also like being able to dig deeper into my Lingo Count data. Users can view term counts for a week, a month, or all time periods. It also shows you what time of day you tend to experience your biggest spikes, which for me is usually at night.
To get the most out of Lingo Count, you need to log your food and exercise in the app. It’s basically simple, but the app glitches sometimes. I often have to click repeatedly on an input box to get it to let me type or make a selection, but it always works for me in the end.
Lingo Count is the crown jewel of the Lingo experience, but there are many other nice features in the app. For example, Abbott has a challenge tab that helps educate users and keep them engaged throughout their day.
These challenges are fun and usually involve small changes you can make to help reduce blood sugar spikes. You decide how many days each challenge lasts. One challenge I completed encouraged me to close the kitchen after dinner to avoid late night snacking. This week, I challenged myself to drink three liters of water every day.
Abbott also provides Lingo users with a wealth of articles, videos, and recipes in the Discover tab. I recommend that you read these carefully, especially if you are new to blood sugar management. I think the company does a great job of explaining glucose in simple, easy-to-understand language.
I’m not good at eating a balanced breakfast, so I tried some of Abbott’s omelet and overnight oats recipes. I will definitely be returning to many of these in the future.
Overall, I really enjoyed my experience using Lingo, and I would definitely recommend it to family and friends. It’s easy to use and wear, and the Lingo Count helps me better understand how my dietary choices affect my body over time.
Please feel free to send any tips, suggestions, story ideas and data to Ashley at ashley.capoot@nbcuni.com.
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