If you or a loved one are living with type 2 diabetes, chances are you have heard about GLP-1 medications. These drugs, which include popular brands like Ozempic and Trulicity, work by stimulating the release of insulin and reducing appetite to help control blood sugar levels. While they have been proven effective in managing diabetes, their increasing use and cost within Medicare has raised concerns about affordability for patients.
According to a recent analysis by the Kaiser Family Foundation, Medicare spending on GLP-1 medications has increased significantly in recent years. In 2014, Medicare Part D spending on these medications was around $300 million, but by 2019, it had reached over $4 billion – a 13-fold increase. This rise in spending is largely due to the growing number of beneficiaries using GLP-1s, which has more than doubled from 2014 to 2019.
One major factor contributing to the rising costs of GLP-1s within Medicare is their high list prices. In 2019, the average annual list price for these medications was nearly $4,000 per beneficiary. This is significantly higher than other commonly used diabetes drugs and has led to increased out-of-pocket costs for patients.
Another reason for the increase in spending on GLP-1s is the lack of generic alternatives. These medications are still relatively new, and their patent protections prevent other companies from creating cheaper versions. This lack of competition drives up prices and limits options for patients.
The increasing costs of GLP-1s within Medicare have real consequences for patients. Many seniors living with diabetes may already be on a fixed income and struggle to afford their medications. The high prices of GLP-1s can also lead to higher out-of-pocket costs, which may cause patients to skip doses or abandon treatment altogether.
To address these concerns, some experts suggest implementing policies that promote competition among drug manufacturers and encourage the development of generic alternatives. This could help lower the costs of GLP-1s and make them more affordable for patients.
Additionally, Medicare beneficiaries can explore their coverage options to find a plan that best meets their needs and budget. The Medicare website (www.medicare.gov) offers resources for comparing drug plans and finding prescription assistance programs.
While GLP-1 medications have shown great promise in managing type 2 diabetes, their increasing use and costs within Medicare have raised concerns about affordability for patients. By understanding the factors driving these rising costs and exploring coverage options, individuals can make informed decisions to better manage their diabetes care. It's important to stay informed and advocate for policies that promote affordable access to essential medications. Your health and financial well-being may depend on it.
Kaiser Family Foundation (2020). Medicare Spending on Ozempic and Other GLP-1s Is Skyrocketing. Retrieved from https://www.kff.org/policy-watch/medicare-spending-on-ozempic-and-other-glp-1s-is-skyrocketing/
Centers for Medicare & Medicaid Services (n.d.). Compare drug and health plans. Retrieved from https://www.medicare.gov/drug-coverage-part-d/compare-drug-plans
You can find out if you qualify for GLP-1 medication in less than 5 minutes by taking our weight-loss quiz.
Take the Quiz
Discover. Evolve. Transform.
.svg)
.svg)
.svg)
.svg)