for some recipients with heart disease risk could drive up the cost of monthly premiums for many of the 65 million adults enrolled in the federal health insurance program,
A handful of Part D providers, including CVS Health and Kaiser Permanente, have already said they would start covering Wegovy for patients with heart disease risk. Every major insurance company has been asked for comment. It’s unlikely that a rise in monthly premiums linked to Wegovy will happen within the next year, said Jeffrey Davis, the health policy director at McDermott and Consulting, a group that provides data analytics and policy advice to the health care industry.
“This drug is expensive,” Davis said. “If millions of people are covered, it could increase premiums going forward.” Some commercial insurers, for example, might start patients off with an older weight-loss medication before they’re allowed to get prescribed a GLP-1 drug.
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