A new program will work to help older Americans afford medication that helps with weight loss.
Kinney Drugs Director of Clinical Services Natalie Powers said she’s seeing the popularity of GLP-1 weight loss medications.
"They've demonstrated meaningful benefits for weight management and overall health,” said Powers. “A lot of times, we need them to be combined with diet, exercise, and ongoing medical care, but they are a very hot topic."
GLP-1 medications can also be very expensive, sometimes as much as $1,000 per month. But start July 1, a new program allows some older Americans who use Medicare Part D to receive select GLP-1 medications for $50 per month.
The Medicare GLP-1 Bridge Program applies to Wegovy, Zepbound, and Foundayo.
There are specific areas of eligibility, depending on the patient’s BMI and other diagnosed conditions.
Power said there are three eligibility buckets. The first is if a patient has a BMI of 35 or higher. The second is a BMI of 30 or higher, plus a diagnosis of heart failure, uncontrolled hypertension, or chronic kidney disease (Stage 3A or higher). The third is if a patient has a BMI of 27 or higher plus pre-diabetes, a history of heart attack or stroke, or symptomatic peripheral artery disease.
Powers said the CMS bridge program is scheduled to run for the next 18 months, so interested patients should act quickly if they think they may be eligible.
"In this population in particular, CMS is really going to be looking at this pilot program over the next several months to make sure that these medications are improving health outcomes and the overall health of these patients,” she said.
Powers said the first step for interested patients is to check with their doctors to see if a GLP-1 is right for them, and whether they fall into one of the eligible categories.
Then, their pharmacist can get authorization from the bridge program.
