The Centers for Medicare and Medicaid Services (CMS) is considering the inclusion of Novo Nordisk’s NVO obesity drug Wegovy in its coverage for heart disease patients with obesity.
What Happened: The CMS is reviewing the FDA's action to expand the use of Wegovy to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and either obesity or overweight, reported Bloomberg, citing a spokesperson in an email.
Medicare, the federal health insurance program for the elderly and some people on long-term disability, currently does not cover weight-loss drugs. However, the recent FDA approval of Wegovy’s expanded label has prompted CMS to reconsider its coverage policy.
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The Congressional Budget Office (CBO) has also indicated that Medicare may cover drugs like Wegovy for the treatment of cardiovascular conditions among people with obesity if the FDA expands the label. The CBO is currently refining its projection of other conditions likely to be covered by Medicare, according to the report.
"Regarding Medicaid coverage, states would be required to cover Wegovy for the purposes to prevent cardiovascular disease in people with obesity,” CMS said. About a third of state Medicaid programs currently cover Wegovy, sold by Novo Nordisk, and other GLP-1 drugs for weight loss.
Why It Matters: The recent FDA approval of Wegovy’s expanded label is a significant development. The drug has been hailed as a game-changer in the treatment landscape for individuals dealing with obesity and established cardiovascular disease. This approval marks a new era in preventive health strategies, aiming to significantly reduce major adverse cardiovascular events (MACE).
Novo Nordisk’s decision to introduce Wegovy in Japan, in response to the country’s rising obesity rates, is another indication of the drug’s combating illicit sales and counterfeit versions of its weight-loss drugs globally due to the remarkable demand for them.
In a bid to combat illicit sales and counterfeit versions of Wegovy, Novo Nordisk has been taking action globally. This includes collaborating with India’s online marketplace, IndiaMART, to remove unauthorized listings of Wegovy. This move followed discussions with IndiaMART, resulting in the removal of numerous listings after sellers were notified about the trademark requirement for Wegovy.
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