Medicare coverage of obesity medications could drive a substantial rise in healthcare spending, according to a new study.
A microsimulation model published in JAMA Health Forum projected that Medicare expenditures would increase by $47.7 billion over 10 years if drugs such as Wegovy and Zepbound were covered under Medicare Part D.
The study, led by David Kim, PhD, an assistant professor of public health sciences at the University of Chicago, modeled a population of 30 million Medicare beneficiaries. While the model estimated $18.2 billion in savings from reduced obesity-related conditions, the high prices of the drugs — at $8,412 annually for semaglutide, the active ingredient in Wegovy, and $6,236 for tirzepatide, the active ingredient in Zepbound — would offset much of the gains.
CMS recently declined to move forward with a proposed rule to cover obesity drugs starting in 2026 but left the possibility open for future consideration.