Ozempic is becoming cheaper for seniors covered by Medicare

The news: Amid persistent demand, the prices of Novo Nordisk’s Ozempic and Rybelsus GLP-1s have dropped considerably for seniors covered by Medicare, according to a recent report from the Department of Health and Human Services (HHS).

• Ozempic and Rybelsus are branded versions of semaglutide, the active ingredient in both GLP-1s.
• For context, Medicare Part D plans are prohibited by law from covering GLP-1s for weight loss only. To be covered, a GLP-1 must be prescribed for another condition like diabetes or heart disease.

Digging into the details: In 2024, the US list price for a month’s supply of Ozempic or Rybelsus is $968, per the HHS. But the net prices—which factor in payer negotiations and rebates—are far cheaper and have dropped over time.

• Ozempic’s net price has fallen from $531 to $290, or 45% since 2018, when the medication was introduced.
• Rybelsus’s net price has dropped from $376 to $296, or 21% since 2020, the first full year the GLP-1 was available.

Why it matters: More affordable prices for GLP-1s can broaden Medicare beneficiaries’ access to these cost-prohibitive medications.

This is especially important in light of a recently announced proposal from the Biden administration that would require Medicare to cover GLP-1s for weight loss.

• Approximately 3.4 million Medicare beneficiaries would become eligible for the drugs.
• If Medicaid is included, which Biden has called for, an additional 4 million enrollees would also gain access to GLP-1s.

Our take: More affordable GLP-1s would be a certainty should Biden’s proposal be approved, which President-elect Donald Trump’s administration will decide.

At the same time, increased spending on GLP-1s by Medicare could threaten the very future of the federal health insurance program itself.

• If 50% of US adults with obesity took a GLP-1 medication for weight loss, it would cost the nation $411 billion annually and bankrupt Medicare, per the Senate Committee on Health, Education, Labor, and Pensions.

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