Approximately 1 in 4 (3.6 million) Medicare beneficiaries diagnosed with obesity also have diagnoses of cardiovascular disease
Estimated cost for Medicare to cover Wegovy is significant, out-of-pocket costs could range from $325 to $430 per month
FDA approves Wegovy for reducing risk of cardiovascular death, heart attack, and stroke in patients with obesity and cardiovascular disease
FDA granted approval based on results from a multinational study conducted by Novo Nordisk, reduction of major adverse cardiovascular events was 20%
Medicare currently prohibited from covering weight loss medications, potential coverage depends on individual Part D plans
In recent news, the Food and Drug Administration (FDA) has approved Wegovy for reducing the risk of cardiovascular death, heart attack, and stroke in patients with obesity and cardiovascular disease. This approval opens up a potential new avenue for Medicare coverage for this drug. According to a KFF analysis, approximately 1 in 4 (3.6 million) of the 13.7 million people on Medicare diagnosed with obesity also have diagnoses of cardiovascular disease (CVD). This means that a significant number of Medicare beneficiaries could potentially be eligible for coverage of Wegovy.
However, it is important to note that Medicare is currently prohibited from covering weight loss medications due to the Medicare Modernization Act of 2003. The passage of the Treat and Reduce Obesity Act (TROA) could change this, but as of now, coverage for Wegovy would depend on individual Part D plans.
The estimated cost for Medicare to cover Wegovy is significant. If just 10% of eligible beneficiaries used the drug in a given year, Medicare would incur an additional net $2.8 billion in Part D spending. Out-of-pocket costs for beneficiaries could range from $325 to $430 per month.
The FDA granted Wegovy approval based on results from a multinational study conducted by Novo Nordisk, the manufacturer of Wegovy. The study found that the drug reduced the risk of major adverse cardiovascular events by 20%. However, it is important to note that the mechanism for this reduction was not established in the study.
It is crucial to remain skeptical and consider potential biases when reporting on this topic. The mainstream media may present information on Wegovy and its potential coverage under Medicare with a bias towards one position or another. It is essential to seek out diverse sources and evaluate all available evidence before drawing any conclusions.
More than 3 million Medicare patients could be eligible for coverage of Wegovy
FDA approved Wegovy for reducing heart disease risks in March
Certain Medicare prescription drug plans may wait until 2025 to cover Wegovy
Under new guidance, Medicare Part D plans can cover Wegovy for patients who are obese or overweight, have a history of heart disease and prescribed the weekly injection to reduce their risk of heart attacks and strokes
Out-of-pocket costs for Wegovy could be around $325 to $430 per month for some beneficiaries
New Part D cap on out-of-pocket spending would limit beneficiaries’ costs to around $3,300 in 2024 and $2,000 in 2025
Accuracy
][Article.facts[0]] More than 3 million Medicare patients could be eligible for coverage of Wegovy
[OtherArticles[0].facts[0]] About 3.6 million Medicare enrollees may qualify for coverage of the anti-obesity drug Wegovy
[Article.facts[1]] FDA approved Wegovy for reducing heart disease risks in March
[OtherArticles[1].facts[2]] The FDA has approved Wegovy for reducing the risk of cardiovascular death, heart attack and stroke in patients with cardiovascular disease and obesity.
[Article.facts[3]] Certain Medicare prescription drug plans may wait until 2025 to cover Wegovy
[OtherArticles[3].facts[7]] Part D plans cannot currently cover Wegovy for weight loss alone, but they can do so if the patient is obese or overweight, has a history of heart disease and is prescribed it to reduce heart attack and stroke risks
Deception
(80%)
The article provides accurate information about the number of Medicare patients who may be eligible for coverage of Wegovy and the potential costs they may face. However, there are instances of selective reporting and emotional manipulation that lower the score. The author focuses on the potential financial burden for some beneficiaries without mentioning that many will not face such costs due to Medicare coverage or other factors. This creates an impression of a larger problem than what is actually the case. Additionally, phrases like 'highly popular and expensive drug' and 'significant burden for those who live on modest incomes' are emotionally manipulative and intended to elicit sympathy from readers.
But some eligible beneficiaries could still face out-of-pocket costs for the highly popular and expensive drug, KFF said.
More than 3 million people with Medicare could be eligible for coverage of Wegovy now that the blockbuster weight loss drug is also approved in the U.S. for heart health, according to an analysis released Wednesday by health policy research organization KFF.
Those sums are a significant burden for those who live on modest incomes.
An estimated 7% of Medicare enrollees, including just over a quarter of those diagnosed as overweight or obese, fit the criteria for Wegovy coverage in 2020
Just how many beneficiaries start taking Wegovy depends on several factors, including how many insurers add it to their Part D formularies
Accuracy
About 3.6 million Medicare enrollees may qualify for coverage of the anti-obesity drug Wegovy
Medicare announced that Part D drug plans could start covering Wegovy for beneficiaries who are overweight or obese and have a history of heart disease
The price tag for Medicare could approach $3 billion for one year if just 10% of eligible beneficiaries use Wegovy and if Part D plans receive a 50% rebate on the list price of $1,300 a month
Medicare is facing steep increases in spending on GLP-1 drugs, with $5.7 billion spent on Ozempic and other similar diabetes drugs in 2022
Deception
(100%)
None Found At Time Of
Publication
Fallacies
(95%)
The article contains some inflammatory rhetoric and an appeal to authority, but no formal or dichotomous fallacies are present. The author states that Medicare is facing steep increases in spending on GLP-1 drugs and quotes KFF's analysis of the potential cost of Wegovy coverage for Medicare. This statement does not constitute a formal fallacy as it is based on factual information from a reputable source (KFF). The author also states that 'Medicare is banned by law from covering anti-obesity drugs,' which is an appeal to authority as it implies that the law itself prohibits coverage, rather than explaining why the law exists or what it specifically states. However, this does not significantly impact the overall score as there are only a few instances of fallacious reasoning in the article.
] Medicare is banned by law from covering anti-obesity drugs[
It could wind up costing Medicare nearly $3 billion a year and contribute to higher Part D premiums for all beneficiaries.
The FDA approved Wegovy for reducing the risk of cardiovascular death, heart attack and stroke in patients with cardiovascular disease and obesity.
Approximately 1 in 4 (3.6 million) of the 13.7 million people on Medicare diagnosed with obesity also have diagnoses of cardiovascular disease.
Medicare is prohibited from covering weight loss medications due to the Medicare Modernization Act of 2003.
Accuracy
Approximately 1 in 4 (3.6 million) Medicare beneficiaries with obesity also have diagnoses of cardiovascular disease.
If just 10 percent of Medicare beneficiaries with obesity or overweight used Wegovy in a given year, Medicare would incur an additional $3 billion in Part D spending.
Part D plans cannot currently cover Wegovy for weight loss alone, but they can do so if the patient is obese or overweight, has a history of heart disease and is prescribed it to reduce heart attack and stroke risks.
Deception
(100%)
None Found At Time Of
Publication
Fallacies
(95%)
The article contains an appeal to authority fallacy when it states 'The FDA granted Wegovy approval last month for reducing the risk of cardiovascular death, heart attack and stroke in patients with cardiovascular disease and obesity.' The statement implies that because the FDA approved the drug, it must be effective for reducing the risk of cardiovascular events. However, this does not necessarily mean that the mechanism of action for this reduction was established in the study or that there are no other potential risks associated with taking Wegovy.
The FDA granted Wegovy approval last month for reducing the risk of cardiovascular death, heart attack and stroke in patients with cardiovascular disease and obesity.
Medicare spent $5.7 billion on Ozempic and other diabetes drugs in 2022.
Part D’s coverage of Wegovy could potentially increase Medicare Part D costs and premiums.
Accuracy
No Contradictions at Time
Of
Publication
Deception
(30%)
The article makes selective reporting by focusing on the fact that Medicare does not cover Ozempic and Mounjaro for weight loss, while mentioning that Wegovy is now covered in certain cases. It also implies that these drugs are expensive without providing context about the potential health benefits or cost savings from reducing cardiovascular disease. The author does not disclose sources for some of the statistics mentioned in the article.
But it’ll impact Part D and when we’ll see those effects, Jung said.
Cawley said he remains cautious about GLP-1s because there may be side effects we don’t know about, but he noted they’ve been prescribed since 2005 and have shown to reduce cardiovascular risk.
Medicare Part D does not provide coverage for GLP-1s if you’re just trying to lose weight, said John Cawley, a professor of economics and public policy at Cornell University.
Fallacies
(85%)
The author makes an appeal to authority when quoting John Cawley and James Bailey. She also mentions the high cost of the drugs as a reason for Medicare not covering them, which could be considered an appeal to emotion if presented in a more inflammatory way.
He noted this means a high percentage of Medicare recipients who have obesity won’t be able to get access to these weight loss drugs.
Part D’s coverage of Wegovy could increase the Medicare Part D costs, in turn increasing premiums.
But it’s unclear how much it’ll impact Part D and when we’ll see those effects, Jung said.
Medicare is prohibited from covering weight loss medications due to the Medicare Modernization Act of 2003.
Accuracy
No Contradictions at Time
Of
Publication
Deception
(50%)
The article contains selective reporting as it only reports details that support the author's position about Wegovy being approved for heart health and its potential coverage under Medicare. It does not mention any potential negative effects or controversies surrounding the drug. The article also uses emotional manipulation by implying that some beneficiaries will face significant financial burdens due to out-of-pocket costs, creating a sense of sympathy and urgency.
But some beneficiaries could still face out-of-pocket costs for the highly popular and expensive drug, and certain Medicare prescription drug plans may also wait until 2025 to cover Wegovy.
Medicare's budget could be strained as more Part D plans cover the costs of Wegovy.
More than 3 million people with Medicare could be eligible for coverage of Wegovy now that the popular weight loss drug is also approved in the U.S. for heart health, according to an analysis by health policy research organization KFF.
Fallacies
(90%)
The article contains a few informal fallacies and an appeal to authority. It uses an inflammatory rhetoric by mentioning the potential strain on Medicare's budget due to Wegovy coverage. Additionally, it quotes certain statistics from KFF analysis without critically evaluating them. However, no formal logical fallacies are present in the article.
. . . some beneficiaries could still face out-of-pocket costs for the highly popular and expensive drug . . .
