Medicare Part D plans can now cover Eli Lilly's obesity drug Zepbound for patients with obstructive sleep apnea, expanding its accessibility.
Medicare drug plans can now cover Eli Lilly's blockbuster obesity drug Zepbound for obstructive sleep apnea , the Centers for Medicare & Medicaid Services confirmed to CNBC. That opens the door for broader coverage of and access to Zepbound , which is not currently covered by Medicare and many other insurance plans for weight loss specifically. Medicare Part D plans can cover obesity drugs if they are used for an additional medically accepted purpose approved by the Food and Drug Administration.
That opens the door for broader access to Zepbound, which is not currently covered by Medicare and many other insurance plans for weight loss. Demand for the injection has soared over the last year despite its roughly In a statement to CNBC, a spokesperson for the Centers for Medicare & Medicaid Services said'current Medicare Part D and Medicaid coverage rules apply' to Zepbound following itsadditional medically accepted purpose. The spokesperson added that Part D plans may consider using prior authorization – a process where a provider must first get approval from an insurer – for those drugs to ensure they are being used for that specific purpose. The FDA on Dec. 20 cleared Zepbound for patients with obesity and moderate-to-severe forms of obstructive sleep apnea, or OSA, which refers to breathing interrupted during sleep due to narrowed or blocked airways. That made Zepbound the first drug treatment cleared for the estimated 20 million people with those forms of the disease, according to Eli Lilly.of lowering cardiovascular risks. The diabetes counterparts of Wegovy and Zepbound – Ozempic and Mounjaro, respectively – are covered by Medicare and most insurance plans.Both Novo Nordisk and Eli Lilly are studying their weight loss medicines as treatments for fatty liver disease, chronic kidney disease, sleep apnea and more. To be covered, those drugs would need to return late-stage trial results and then be submitted for FDA approval for those use
Medicare Zepbound Obesity Sleep Apnea FDA Approval
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