Medicare's $50 obesity drug program sees early demand, pharmacies say

The prescriptions are part of a pilot called the Bridge program. By law, Medicare is barred from paying for weight loss drugs, but the administration created a workaround: Medicare will cover the drug if a person meets certain conditions, such as having obesity combined with high blood pressure that is hard to control. Beneficiaries are ineligible if they have sleep apnea or Type 2 diabetes, because Medicare Part D should already cover GLP-1 drugs for those conditions. The Bridge program is set to run through the end of 2027.

Walgreens' chief pharmacy officer Rick Gates said stores around the country stocked extra Wegovy, Zepbound and Foundayo to prepare for the July launch. "We expected there would be uptake," he told NPR. "I think there's been a little bit more uptake than we even expected." Gates said Walgreens pharmacies had to adjust as the program got up and running but haven't run into supply issues. Around half of the patients Walgreens has served through the Bridge program had never taken GLP-1s before, he added. "That's the part where pharmacies naturally will lean in," he said, explaining that pharmacists can help patients manage initial side effects like nausea and diarrhea.

CVS says it has filled more than 100,000 Bridge prescriptions as of mid-August. The chain says it also offers options for people not eligible for the program, including third-party discount cards, manufacturer coupons, and vouchers to reduce out-of-pocket costs. Walmart did not provide a number but said Bridge prescriptions have been growing week over week and have been processed at more than 5,000 Walmart and Sam's Club pharmacies nationwide.

Jeremy Shane, a nonresident scholar at the USC Leonard D. Schaeffer Institute for Public Policy & Government Service, said the numbers shared with NPR show seniors are making use of the program. "I think those are big numbers and they're encouraging about the demand for those medications," he said. Medicare had estimated roughly 4 million beneficiaries might qualify. With 200,000 prescriptions already filled and possibly twice as many through other chains, Shane said that represents somewhere between 5% and 10% of the eligible population in a short period.

The Centers for Medicare and Medicaid Services did not provide NPR with enrollment figures, but CMS Administrator Mehmet Oz said in a July 29 video that 250,000 beneficiaries had signed up. It is not clear whether those people obtained required prior authorizations. The administration has not said how much the 18-month program could cost. The health research group KFF estimates the bill could run between $1.3 billion and $10 billion, depending on participation. Shane said the program is an opportunity to consider value over time, citing research that expanding Medicare access to GLP-1s could reduce healthcare spending and improve quality of life.