Pictured: Man prepares his semaglutide injection pen/iStock, imyskin

图为：一名男子准备他的semaglutide注射笔/伊梅斯金（imyskin）伊斯托克（iStock）

An estimated 3.6 million Medicare beneficiaries may now be eligible for coverage of Novo Nordisk’s Wegovy (semaglutide), according to an analysis released by the Kaiser Family Foundation on Wednesday.

据凯撒家庭基金会周三发布的一项分析，估计360万Medicare受益人现在可能有资格获得诺和诺德Wegovy（semaglutide）的保险。

The expanded coverage is thanks to the FDA’s recent approval of the use of Wegovy to reduce the risk of heart attack and stroke in people with cardiovascular disease who are already obese. Using data from 2020, the approval opens access to Wegovy for one in four Medicare beneficiaries with obesity, the Kaiser Family Foundation (KFF) finds. .

覆盖面的扩大归功于FDA最近批准使用Wegovy来降低已经肥胖的心血管疾病患者的心脏病发作和中风风险。凯撒家庭基金会（KFF）发现，根据2020年的数据，该批准为四分之一的肥胖医疗保险受益人开放了Wegovy。。

GLP-1 injectables such as Wegovy have already taken the obesity treatment market to all-time highs, despite a lack of coverage by the Centers for Medicare and Medicaid Services (CMS) under the obesity indication. For now, obesity is excluded from Medicare coverage by law. The list price of Wegovy is right at $1,350 for a four-week supply.

尽管医疗保险和医疗补助服务中心（CMS）在肥胖指征下缺乏覆盖范围，但Wegovy等GLP-1注射剂已将肥胖治疗市场推向历史新高。目前，肥胖被法律排除在医疗保险范围之外。Wegovy的标价为每四周1350美元。

Novo offers discount programs to lower costs, but these programs are not accessible for Medicare and Medicaid beneficiaries.  .

Novo提供折扣计划以降低成本，但医疗保险和医疗补助受益人无法获得这些计划。。

CMS has already approved Wegovy to be covered under its Part D plans with the addition of its “medically accepted indication.” Some Part D plans have announced coverage will begin this year for Wegovy, though it's not yet clear how extensive the coverage will be in 2024.

CMS已经批准将Wegovy纳入其D部分计划，并增加了“医学上可接受的适应症”。一些D部分计划已经宣布将于今年开始覆盖Wegovy，尽管目前尚不清楚2024年的覆盖范围有多广。

The GLP-1 injection may be covered as a specialty tier drug, for which Part D plans are able to charge a coinsurance of 25% to 33%, or $325 to $430, before reaching the $3,300 new annual out-of-pocket cap established by the Inflation Reduction Act. The cap will lower to $2,000 in 2025, both limits based on name brand drugs only. .

GLP-1注射剂可能被列为特级药物，D部分计划可以收取25%至33%的共同保险，或325美元至430美元，然后才能达到3300美元的新年度自付上限。通货膨胀减少法案。2025年，上限将降至2000美元，这两个限额都仅基于名牌药物。。

Assuming plans receive a 50% rebate on the list price and 10% of the target population use the drug for a full year, KFF’s analysis pegged Medicare Part D spending at $2.8 billion for one year on this drug alone. Wegovy is the label name of Novo’s previously approved diabetes drug Ozempic.

假设计划在标价上获得50%的折扣，并且目标人群中有10%全年使用该药物，KFF的分析表明，仅在该药物上一年的Medicare D部分支出就为28亿美元。Wegovy是Novo先前批准的糖尿病药物Ozempic的标签名称。

Because Ozempic was approved in 2017, the seven-year time limit is almost up to allow CMS to select the drug for price negotiation as early as 2025. Ozempic was sixth among the 10 top-selling drugs covered by Medicare Part D.

由于Ozempic于2017年获得批准，因此七年的时间限制几乎达到了允许CMS最早在2025年选择该药物进行价格谈判的程度。Ozempic在医疗保险D部分涵盖的10种畅销药物中排名第六。

With the laundry list of comorbidities for obesity, GLP-1 drugs are a tool that can have a major impact beyond weight loss. In addition to Novo’s evidence of lowering cardiovascular risk, another recent study from Eli Lilly showed its GLP-1 tirzepatide alleviated sleep apnea symptoms, reducing patients’ mean apnea-hypopnea index up to 63%.  .

有了肥胖合并症的详细清单，GLP-1药物是一种除了减肥之外还可以产生重大影响的工具。除了Novo降低心血管风险的证据外，礼来公司最近的另一项研究表明，其GLP-1替罗巴肽缓解了睡眠呼吸暂停症状，使患者的平均呼吸暂停低通气指数降低了63%。。

GLP-1 demand is surging. In 2023, the drug type made up for nearly half of expenditures in the endocrine drug class at over $63 billion, according to STAT News.

GLP-1需求激增。据《统计新闻》报道，2023年，该类药物占内分泌类药物支出的近一半，超过630亿美元。

Kate Goodwin is a freelance life science writer based in Des Moines, Iowa. She can be reached at kate.goodwin@biospace.com and on LinkedIn.

凯特·古德温是爱荷华州得梅因的一名自由生命科学作家。她的联系电话是kate.goodwin@biospace.com和LinkedIn。