New KFF poll finds most of the adults who have taken GLP-1 therapies have diabetes or heart disease. But 38% said they have used for these drugs solely to lose weight.
About 12% of adults have used GLP-1 drugs either to treat diabetes or to lose weight, according to the latest KFF Health Tracking Poll. Of those who report taking the GLP-1 drugs, 43% have diabetes, 26% have heart disease and 22% have obesity or overweight (22%).
KFF’s latest Health Tracking Poll examines the public’s views on the GLP-1 drugs such as Ozempic (semaglutide), Wegovy (semaglutide) and Mounjaro (tirzepatide). KFF surveyed almost 1,500 people between April 23, 2024, and May 1, 2024, online and by telephone. The sample was weighted to match the demographics to the national U.S. adult population.
About half (54%) of those who report taking the GLP-1 therapies say it was difficult to afford them, including those who have insurance that covered some of the cost. In the U.S., list prices for GLP-1 drugs can range from $936 to $1,349 before insurance coverage, rebates or coupons.
Among those 65 years of age and older, 9% report ever taking the drugs but few (1%) say they did so solely for weight loss. Medicare Part D is unable to cover weight loss medications because of the way the law was written. But Medicare provides coverage for the GLP-1 therapies that treat patients with diabetes or other medically accepted indications.
Related: Medicare’s Spending on Ozempic and Other GLP-1s Rises Steeply
In March 2024, KFF reported that in 2022, gross total Medicare spending for GLP-1 therapies used to treat diabetes reached $57 billion, up from $57 million in 2018. KFF looked at Medicare Part D spending before rebates of Ozempic, Rybelsus (semaglutide), and Mounjaro.
In the current survey, 61% of respondents said Medicare should provide coverage of the GLP-1 drugs for weight loss. The survey found that this was similar across all age groups.
Wegovy’s approval in March 2024 for a new indication could open the door for more coverage some Medicare beneficiaries. The FDA approved Wegove (semaglutide) to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and either obesity or overweight.
The approval is based on the SELECT cardiovascular outcomes trial, which demonstrated that Wegovy statistically significantly reduced the risk of major adverse cardiovascular events (MACE) by 20% compared with placebo when added to standard of care.
CMS issued a memo indicating that Medicare Part D plans can add Wegovy to their formularies now that it has a medically-accepted indication that is not specifically excluded from Medicare coverage.
KFF analyzed Medicare data from 2020 and estimated that 7% of Medicare beneficiaries, or 3.6 million overall, had established cardiovascular disease and obesity or overweight, and could be eligible for Medicare coverage of Wegovy for its new indication. KFF estimates that if just 10% patients use Wegovy for this new indication for one year, it would mean an additional $2.8 billion in Medicare spending for that year. As of 2022, gross Medicare spending on Ozempic alone it among the 10 top-selling drugs in Medicare Part D, with annual gross spending of $4.6 billion, based on KFF analysis.
At least one bill has been introduced in the Senate to expand coverage in Medicare for obesity treatments. Sponsored by Sen. Thomas Carper (Dem.-Del.), the bipartisan bill would expand coverage for medications and provide for regular screenings. It has been referred to the Committee on Finance.
“By tackling obesity head on, we can better prevent numerous additional diseases such as heart disease and diabetes, helping lengthen Americans’ health spans while also saving taxpayer and Medicare dollars over the long run,” cosponsor Brad Wenstrup (R-Ohio) said in a news release when the bill was introduced in September 2023.
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