Medicare Coverage For Lilly’s Tirzepatide Could Be ‘Unlocked’ With Heart Failure, Apnea Claims
The problem that obesity drugs are not covered by Medicare Part D might be alleviated if Lilly’s weight loss candidate is also cleared for indications that are reimbursed. Policy and treatment experts discuss the importance of proving obesity drugs can lower federal government health care spending during a recent discussion convened by the Institute for Clinical and Economic Review.
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Wegovy and Saxenda surpass cost effectiveness thresholds at current prices, while two widely unused drugs, Qysmia and Contrave, are cost-effective at accepted benchmarks, according to a draft report from the Institute for Clinical and Economic Review.
“Scoring” Savings From Obesity Drugs: CBO Points To Gap Between Categories In Rx Labels And Economic Impact
Proposals to expand Medicare coverage to include obesity therapies are unlikely to be treated as cost-effective by CBO without significant new research on the long term impact of relatively modest changes in BMI. Advocates for coverage may need to focus on other arguments instead.
US Health and Human Services Department revises approach to 340B administrative dispute resolution process and presiding panel in proposed rule.