Medicare Will Not Expand Coverage for Weight-Loss Drugs, CMS Confirms
- GOT Pharmaceutical
- Apr 6
- 2 min read
The Centers for Medicare & Medicaid Services (CMS) has confirmed that it will not proceed with a previously proposed plan to expand Medicare coverage for weight-loss medications, including popular GLP-1 drugs such as Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound.
This decision marks a reversal from earlier proposals under the Biden administration, which had aimed to broaden access to newer GLP-1 therapies shown to support significant weight reduction and help prevent type 2 diabetes. These treatments, which can cost patients upwards of $1,000 per month without insurance, remain financially out of reach for many.
Currently, Medicare only covers GLP-1 medications like Ozempic (Novo Nordisk) and Mounjaro (Eli Lilly) when prescribed for diabetes - not for obesity, even when the medications have received FDA approval for weight management.
The market responded quickly to the CMS announcement. Novo Nordisk shares fell by 1.4% in after-hours trading, while Eli Lilly saw a 3.1% drop.
Analysts noted the decision came as little surprise. Courtney Breen of Bernstein commented that with pharmaceutical trade issues still in flux, this may not be the time for the administration to make large-scale policy shifts without negotiation leverage.
Lilly expressed disappointment in the outcome, stating its ongoing commitment to working with the current administration and Congress to secure coverage for obesity treatments under Medicare and Medicaid. Novo Nordisk echoed that sentiment, emphasizing the need for CMS to align its regulations with up-to-date scientific understanding - particularly by officially recognizing obesity as a chronic disease.
Health and Human Services Secretary Robert F. Kennedy Jr. has previously suggested that addressing obesity should prioritize lifestyle changes, such as improved diet and nutrition, rather than pharmaceutical intervention.
In addition to shelving the weight-loss drug proposal, CMS also opted not to advance two other measures: one requiring Medicare providers to assess their policies through a health equity lens, and another that proposed tighter regulations on artificial intelligence tools used in healthcare decision-making.
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