Medicare will present protection for Wegovy for sufferers with an elevated threat of coronary heart assault, stroke or different severe cardiovascular issues, an company spokesperson mentioned Thursday.The choice, specialists say, might grant hundreds of thousands of sufferers entry to the favored but costly weight reduction medicine.Medicare, which at present gives medical insurance to greater than 65 million individuals within the U.S., has lengthy been barred from paying for weight reduction medicine.Earlier this month, nevertheless, the Meals and Drug Administration expanded the approval for Wegovy, saying that it may be prescribed to people who find themselves chubby or have weight problems to cut back their threat of coronary heart illness.The change prompted the Facilities for Medicare and Medicaid Providers to think about protection as a result of lowering coronary heart illness threat is a medically accepted use below federal legislation, the spokesperson mentioned. Medicare will nonetheless not cowl Wegovy if it is just getting used for weight administration, the spokesperson mentioned. Medicaid, the federal medical insurance program for individuals with low incomes, will even be required to cowl Wegovy to cut back coronary heart illness threat.RecommendedLawrence Gostin, director of the O’Neill Institute for Nationwide and International Well being Legislation at Georgetown College, mentioned Medicare offering protection for Wegovy is “transformational.”However doing so might undermine Medicare’s “monetary stability,” Gostin mentioned. The drug carries a listing worth of round $1,200 a month, and plenty of sufferers will doubtless desire a prescription.A survey from the College of Michigan Nationwide Ballot on Wholesome Growing old in December discovered about 3 in 4 older adults imagine Medicare ought to cowl weight reduction drugs.A weblog put up from the Congressional Funds Workplace final October mentioned that if Medicare did cowl weight reduction drugs resembling Wegovy, the online price to this system “could be vital over the following 10 years.”“There may very well be a slippery slope the place Medicare finally ends up paying for the drug for use for weight reduction functions,” Gostin mentioned. “That will bankrupt Medicare and trigger a taxpayer revolt.”Juliette Cubanski, deputy director of the Medicare coverage program at KFF, a nonpartisan group that research well being coverage points, mentioned that whereas Medicare will not cowl the drug solely for weight reduction, many individuals with coronary heart illness are chubby or have weight problems. “We might see Medicare sufferers with each circumstances get protection of this drug for its coronary heart well being advantages,” Cubanski mentioned. “That’s probably an enormous deal given the big demand for this drug even within the absence of many insurers overlaying it.”The drug can be coated below Medicare Half D, which covers the price of drugs individuals take at dwelling, the spokesperson mentioned.It’s not clear how non-public insurance coverage corporations that supply supplemental Half D protection will reply, Cubanski mentioned, noting that plans do have the flexibility so as to add new medicine to the checklist of medicine they cowl in the midst of the yr, “however given the price of this drug, plans won’t need to be the primary movers.”Berkeley Lovelace Jr. is a well being and medical reporter for NBC Information. He covers the Meals and Drug Administration, with a particular concentrate on Covid vaccines, prescription drug pricing and well being care. He beforehand coated the biotech and pharmaceutical business with CNBC.