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Medicare Part D Coverage of Antiobesity Medications

The use of new-generation antiobesity medications in older adults presents “challenges and uncertainty” to the Medicare Part D program, Perspective authors write: “The burden of obesity and obesity-related conditions is unquestionably high, but the value of Medicare coverage of antiobesity medications remains unclear. Depending on the types of medications used by beneficiaries and their rate of use, it’s likely that Part D premiums would increase to accommodate spending on these products. To the extent that other payers follow Medicare’s lead, such costs could be felt throughout the U.S. health care system. A thorough understanding of the health benefits and risks associated with antiobesity-medication use, particularly in the Medicare population, is needed to guide coverage and reimbursement decisions so that access is focused on the people most likely to benefit. Given the potential budgetary effects of antiobesity medications on Medicare Part D and remaining questions about their benefits among older adults, it would be prudent for Congress and the Centers for Medicare and Medicaid Services to carefully consider the potential trade-offs associated with antiobesity-medication coverage and use for Medicare beneficiaries.”

Source: New England Journal of Medicine