April 25, 2025

A recent publication from the Kim Research Group has prompted continued discussions about Medicare’s coverage policy of GLP-1s to treat obesity. Dr. Jennifer Hwang and coauthors found that expanding coverage of anti-obesity medications would cost an estimated $65.9 billion over the next 10 years. It would also save $18.2 billion by preventing obesity-related healthcare costs, resulting in net costs of $47.7 billion.

In a conversation with Healio, Dr. David Kim said:

“These are important numbers, because a lot of people say that GLP-1s will save a lot of money in health care because obesity is a risk factor for many other conditions. … Our paper highlighted that in some sense, GLP-1s do save money, but not enough to offset the high prices of the medication.”

In 2024, the Biden Administration’s CMS published a proposal for Medicare to cover GLP-1s for the treatment of obesity, an expansion on existing policy of coverage only for treatment of FDA-covered indications, like diabetes. On April 15th, 2025, the second Trump administration’s CMS eliminated that proposal from its final rule governing Medicare and Medicaid coverage in 2026. Five US Senators sent a letter to HHS Secretary Robert F. Kennedy Jr. urging reconsideration of the decision, citing the high cost of treating obesity.

A CMS spokesperson left the door open for future consideration with “further review of both the potential benefits of these drugs including updated clinical indications, and relevant costs including fiscal impacts on stakeholders such as state Medicaid agencies”. 

Additional coverage from AJMC