Last week, The Trump administration reversed a Biden-era proposal for Medicare coverage of anti-obesity treatments. But on Monday, HHS suggested it is open to future policy considerations toward this end.
The Trump administration last week made the decision to do away with a Biden-era proposal to cover anti-obesity medications under Medicare’s Part D program. However, the Department of Health and Human Services isn’t completely slamming the door.
In a statement to Endpoints News on Monday, an HHS spokesperson said that while the proposal “is not appropriate at this time,” the Department “may consider future policy options” for anti-obesity medications, depending on their cost-benefit balance.
The previously proposed coverage would have made it easier for patients to access therapies such as Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound but also would have been very expensive for the government. A monthly course of these drugs goes for around $1,100 and, as per an October 2024 Congressional Budget Office report in October 2024, Medicare coverage could increase federal spending by around $35 billion from 2026 to 2034 as result of these drugs.
“CMS may consider future policy options for [anti-obesity medications] pending further review of both the potential benefits of these drugs including updated clinical indications, and relevant costs including fiscal impacts on stakeholders such as state Medicaid agencies,” the spokesperson told Endpoints.
The mention of additional indications is notable, as this has been a strategy undertaken by both Lilly and Novo. In January, Novo’s Ozempic picked up an FDA approval for treating chronic kidney disease, while in December Lilly’s Zepbound got a label expansion to cover sleep apnea. Novo, Lilly and a bevy of other companies are also investigating obesity drugs in indications like MASH, Alzheimer’s, Parkinson’s and cancer.
Jefferies analyst Roger Song said that Medicare could be the “bellwether” case for expanding coverage to a broader patient population, according to Endpoints.
Big changes have swept through HHS recently.
Since his confirmation as Health Secretary in February, Kennedy has fired thousands of employees from the HHS—including from the FDA—in the name of efficiency. Taking into account those who had voluntarily left, HHS has lost some 20,000 employees, or around 25% of its original headcount, since the start of the year.
Last week, Senators Bill Cassidy (R-LA) and Bernie Sanders (I-VT) wrote to Kennedy asking him to testify at a hearing of the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) scheduled for April 10 to address the massive overhaul. But it looks like that won’t be happening. As per the Committee’s calendar, no hearing has yet been scheduled for that date. Committee hearings must be scheduled at least seven days before.
In a statement to Endpoints News, a staff assistant at HELP’s clerk’s office said the hearing is “definitely not happening” this week. HELP could still convene at a later date to hear Kennedy’s testimony. The Committee will go into recess from April 14 through April 25.
The layoffs are just one part of larger shifts in the Department: Kennedy in March announced that he was creating a new agency—the Administration for a Healthy America—to house existing units such as the Substance Abuse and Mental Health Services Administration and the National Institute for Occupational Safety and Health.
