A new analysis by the Congressional Budget Office (CBO) estimates that expanding Medicare coverage to include weight-loss drugs could cost the U.S. government $35 billion over the next nine years. The report predicts a significant financial burden if these medications, currently restricted to patients with specific comorbidities, are covered solely for obesity.
Medicare, the federal health insurance program for around 54 million Americans over the age of 65, currently covers anti-obesity drugs like Novo Nordisk’s Wegovy only for patients with additional health risks, such as heart disease or sleep apnea. However, drugmakers Novo Nordisk and Eli Lilly are advocating for a change that would allow Medicare to cover these treatments for obesity alone.
The bill under consideration in the U.S. House of Representatives aims to amend the law that prohibits Medicare from covering anti-obesity medications exclusively for weight loss. The CBO’s analysis found that if the coverage expansion begins in 2026, it would cost the government approximately $1.6 billion in the first year for 300,000 patients. By 2034, the costs are projected to rise to $7.1 billion to cover 1.6 million patients.
Despite claims by drug manufacturers that weight-loss medications would lead to long-term savings through improved health outcomes, the CBO report concluded that those savings would be minimal. By 2034, only $1 billion in healthcare savings is expected, leaving a substantial financial gap compared to the cost of the treatments.
Medicare’s current spending on prescription drugs is projected to reach $120 billion in 2024. The debate over covering obesity medications has intensified, with critics like Senator Bernie Sanders warning that the high price of drugs like Wegovy, which costs nearly $1,350 per month, could overwhelm Medicare’s budget.
Both Novo Nordisk and Eli Lilly are working on expanding the approved uses for their obesity drugs by conducting trials for conditions like sleep apnea. They aim to convince regulators and insurers that these treatments should be covered based on broader health benefits beyond weight loss.
While $35 billion is not insignificant, Benedic Ippolito, a senior fellow at the American Enterprise Institute, pointed out that it is far less damaging than earlier predictions that suggested obesity drugs could financially cripple Medicare.
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