WASHINGTON — The Trump administration’s plan for providing cheap weight loss drugs to seniors in Medicare might be falling apart, as some health insurers signal doubts about participating.
Last year, the Trump administration struck a deal with Eli Lilly and Novo Nordisk to lower prices of their popular obesity drugs in exchange for expanding access to those drugs in Medicare and Medicaid. Medicare is prohibited from covering weight loss drugs, so the administration proposed waiving that restriction to test whether covering them would save the program money or improve health outcomes at no additional cost.
The hitch is that insurers must agree to participate in the pilot, called BALANCE, but would likely face a financial drain from doing so. The drugmakers agreed to sell the treatments for $245 a month in Medicare and Medicaid, but Medicare beneficiaries would only pay $50 each month. Continue to STAT+ to read the full story…