However, the direct-to-consumer prices announced by the administration appear to be lower.<\/p>\n
\u201cBringing the price down really is going to impact those people who either don\u2019t have insurance for [GLP-1s] and have been paying out of pocket, or alternatively, those people who have chosen to go the route of purchasing them as compounded versions,\u201d says Cristy Gallagher, with the STOP Obesity Alliance at George Washington University\u2019s Milken Institute School of Public Health.<\/p>\n
Compounded GLP-1s are altered formulations made by a pharmacy, not the manufacturer. They have become popular through telehealth companies, which prescribe and sell them at much lower prices than the brand versions. However, the FDA has warned that they do not undergo federal review for safety, effectiveness and quality before they are marketed.\u00a0<\/p>\n
With lower prices for out-of-pocket purchasing, \u201cthere might be an opportunity for people to switch over to the actual molecules through the company,\u201d Gallagher says. \u201cWe just don\u2019t know exactly everything that\u2019s in some of these compounded medicines.\u201d<\/p>\n
If you have Medicare or Medicaid,<\/b> accessing a GLP-1 could become easier and more affordable.<\/p>\n
Medicare currently covers<\/a> GLP-1s for diabetes and other approved ailments \u2014 such as obesity in conjunction with heart disease<\/a> \u2014 but is legally barred from covering the medication for weight loss alone. However, the announcement from health officials says the new low prices for the federal insurance program \u201cwill enable Medicare to cover Wegovy and Zepbound for patients with obesity and related comorbidities [co-occurring diseases] for the first time.\u201d \ufeff<\/p>\n Beneficiaries who will be eligible for lower-cost GLP-1 medications include individuals with a body mass index (BMI) of 27 or greater who have prediabetes or a history of cardiovascular disease; individuals with a BMI greater than 30 who have heart failure with preserved ejection fraction, uncontrolled hypertension or chronic kidney disease; and individuals with a BMI greater than 35. Coverage is expected to kick in around the middle of next year.<\/p>\n