Home Markets Many insured patients in the US pay less than $25 a month

Many insured patients in the US pay less than $25 a month

by SuperiorInvest

Wegovy, an injectable prescription weight loss medication that has helped people with obesity.

Michael Siluk | UCG | fake images

Nordisk It said Thursday that 80% of American patients with insurance coverage who take its popular Wegovy weight loss treatment pay less than $25 a month for the drug.

Feedback suggests that many insured Americans don’t have to bear the full cost of a monthly Wegovy package, which has a list price of about $1,350. It also comes as many U.S. health insurers balk at the extreme cost of Wegovy and other obesity drugs and remove them from their plans, even as demand for those treatments soars across the country and outstrips supply.

But Doug Langa, Novo Nordisk’s vice president for North America, said Thursday in a third-quarter earnings conference call that most major health plans and pharmacy benefit managers cover Wegovy.

Langa acknowledged that some employers are opting out of coverage, but noted that overall the company is seeing more insurers opting to cover the weekly shot.

It estimated that about 50 million Americans with obesity could be eligible for Wegovy coverage in their health plans.

“Directionally, we are headed in the right direction and our focus will be to continue to ensure employer coverage as well as stronger access for Americans overall,” Langa said during the call.

However, the $25 out-of-pocket cost will likely increase over time. Most patients have to take Wegovy for several months to see (and maintain) significant weight loss.

Wegovy, for example, causes 15% weight loss after 68 weeks, according to clinical trials of the drug.

The longer duration of treatment is also one of the reasons some health insurers are hesitant to cover Wegovy and similar weight-loss drugs, which typically work by mimicking a hormone produced in the intestine to suppress a person’s appetite.

At about $1,000 a month on average for drugs typically taken for months or even a year, the drugs are putting a strain on insurers’ budgets.

But Novo Nordisk hopes new data showing Wegovy’s heart health benefits will put more pressure on insurers to cover the drug and similar weight-loss treatments.

A recent late-stage trial found that Wegovy reduced the risk of cardiovascular events such as heart attacks and strokes by 20%. The results suggest that Wegovy and similar obesity and diabetes drugs, like those being developed by Eli Lilly and others, could have lasting health benefits beyond shedding unwanted pounds.

Novo Nordisk Chief Financial Officer Karsten Munk Knudsen told CNBC on Thursday that Wegovy could receive expanded approval from the U.S. Food and Drug Administration as a treatment to reduce the risk of cardiovascular disease within six months.

According to the National Institutes of Health, more than 2 in 5 adults are obese.

About 1 in 11 adults is severely obese.

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