Medicare is expanding coverage for Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound. Federal law prohibits Medicare Part D from covering drugs solely for weight loss. Coverage applies only to patients with established cardiovascular disease.
Analysts project the expansion could add over $1 billion in annual revenue for each manufacturer. However, the specific patient pool is significantly smaller than the general population with obesity. Pricing pressures and slow uptake may temper the immediate financial impact.
A temporary Medicare GLP-1 Bridge program will run from July 2026 through 2027. This initiative follows hesitation from major private insurers to participate in broader coverage models. The long-term landscape for coverage remains complex.