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Posts tagged with "GLP-1 drugs"

CMS Launches Temporary 18-Month Medicare GLP-1 Pilot with $50 Monthly Copay CMS Rules

CMS Launches Temporary 18-Month Medicare GLP-1 Pilot with $50 Monthly Copay

On July 1, the Centers for Medicare and Medicaid Services (CMS) launched a temporary program to cover GLP-1 agonist drugs for obese Medicare beneficiaries. The program is called the Medicare GLP-1 Bridge and will allow eligible beneficiaries to access the drugs for a $50 monthly copayment. The program is slated to run from July 2026...
CMS Rules

MA Plans Say No to Coverage of GLP-1s, CMS Pivots and Member and Medicare to Pay

As insurance companies raise flags about the cost of GLP-1 weight loss drugs in coordination with government payer programs, the Trump administration has rescinded its plan to have insurance companies fund coverage of the obesity drugs and will have Medicare pay the cost instead. Last year, the White House announced a landmark deal...
PAPER: Popular & Effective GLP-1s Offer Strong Value but Pose Major Budget Challenge News

PAPER: Popular & Effective GLP-1s Offer Strong Value but Pose Major Budget Challenge

Authors contend semaglutide (Wegovy) and tirzepatide (Zepbound) are likely to strain health system budgets if broadly prescribed. The Institute for Clinical and Economic Review (ICER) rated three obesity treatments—including a pending oral semaglutide formulation—as “A” compared with lifestyle changes and estimated...
Milliman Issue Brief: Measuring How GLP-1 Medications Impact Total Cost Of Care News

Milliman Issue Brief: Measuring How GLP-1 Medications Impact Total Cost Of Care

Glucagon-like peptide-1 (GLP-1) medications, often branded as “miracle drugs,” are reshaping payer costs and care management, according to a Milliman issue brief measuring their effect on the total cost of care. While drug spending has surged for Medicare, Medicaid, and commercial insurers, Milliman’s analysis suggests that...
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