Biden wants to make weight-loss drugs more accessible. Will it pass the Trump test?

Good news awaits millions of Americans suffering from obesity and desperate to shed the kilos. The Biden administration has announced a proposal to require Medicare and Medicaid to cover weight-loss drugs.

The Health and Human Services (HHS) Department unveiled the proposal on Tuesday to add anti-obesity drugs like Wegovy, Zepbound, Ozempic and Mounjaro under Medicare and Medicaid plans .

The rule is beneficial for Americans as it would increase access to anti-obesity medications or GLP-1s for millions suffering from obesity, according to a White House fact sheet. Thus, reducing risks of diabetes, stroke and cardiovascular disease among them.

However, questions are being raised on the implementation of the plan under the Trump administration. Several experts doubt that the proposal will find support from President-elect Donald Trump or his pick to head the health services Robert F Kennedy Jr .

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Here is all you need to know about the drugs and the proposal.

How do the drugs function?

Weight-loss drugs, also known as anti-obesity medications or GLP-1s, mimic glucagon-like peptide 1 which is a hormone regulating appetite by signalling fullness between the gut and brain during eating. The drugs include Novo Nordisk’s Wegovy and Ozempic and Eli Lilly’s Zepbound and Mounjaro.

In clinical trials, most participants taking Wegovy or Mounjaro to treat obesity lost an average of 15 per cent to 22 per cent of their body weight — up to 22.5 kilos (50 pounds) or more in many cases. But a slice of “nonresponders” did not lose significant body weight.

Private health insurers have limited coverage of the drugs. Medicare has been barred from covering them under a law that says the programme cannot pay for weight-loss products. Coverage through Medicaid, meanwhile, has varied from state to state. That meant the drugs, which can cost upwards of $1,000 (Rs 84,462) monthly, have been largely unaffordable for many.

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How much money will the plan cost the government?

The proposal, if implemented, will cost billions of dollars to the US government - $35 (Rs 29.5 lakh crore) billion or more to be precise. The rule will affect Medicaid, which provides health care coverage for roughly 70 million of the nation’s poorest people and Medicare, the health insurance programme for about 67 million older Americans.

Under the proposal, the Centers for Medicare and Medicaid Services would reinterpret the federal law, to consider the drugs as a treatment for obesity diseases.

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The nation’s top health agency estimates as many as 3.5 million people on Medicare and 4 million on Medicaid could qualify for coverage of the drugs. But research suggests far more people might qualify, with the Centers for Medicare and Medicaid Services estimating roughly 28 million people on Medicaid are considered obese.

Will Trump support it?

The drugs are popular — with a majority of Americans telling health firm KFF in a poll earlier this year that Medicare should cover the drugs. A bipartisan coalition of lawmakers, too, has lobbied for coverage of the drugs.

But support is mixed in Donald Trump’s inner circle. Kennedy has railed against the idea of Medicare or Medicaid covering the drugs. Instead, he’s told Congress that they should expand coverage of healthier foods and gym memberships through the government-sponsored healthcare programmes.

Meanwhile, Dr Mehmet Oz , who is poised to take the helm of the Centers for Medicare and Medicaid Service, has said the drugs can be a helpful tool. In a video posted to Instagram last year, Oz praised some of the benefits of the drugs but said the long-term effects should be further studied. “I think these new generation of medications offer us a huge opportunity,” Oz said.

How did lawmakers react?

Some lawmakers praised the move on Tuesday, while others expressed scepticism. Brad Wenstrup, a Republican who sponsored a bill to have Medicare cover weight-loss drugs, has argued that covering the drugs and other obesity treatments could save taxpayers in the long run.

“I am encouraged to see the Administration support our efforts to help make Americans healthier by allowing Medicare coverage of new, physician prescribed and FDA approved anti-obesity medications," Wenstrup said in a statement. He called for Congress to pass a law that would help pay for dietitians, nutritionists and behavioural therapy to treat obesity.

Senator Bernie Sanders, however, warned that unless the government required drugmakers to lower the price of the medications Medicare premiums would “skyrocket" under the plan. Doctors praise the drugs but still have concerns. It’s good for more Americans to have access to these drugs, which have proven effective, but Dr David Ludwig, a nutrition and obesity expert at Harvard University, hopes that it doesn’t become the primary way obesity is treated in America.

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He worries that not enough investment is being made to figure out what is driving climbing obesity rates across the US and the role that healthy foods and exercise might play in solving that epidemic. “It’s appropriate to treat the problems that we now face with drugs, but let’s not stop there,” Ludwig said. “Let’s identify what’s causing the problem and ultimately rely on these drugs — which have side effects — less and less over time.”

Dr. Andrew Kraftson, who treats obese patients at the University of Michigan, is happy that more of his patients might be able to afford these drugs, which he has prescribed for patients and has had successful results. But he, too, would like to see more research and guidance from the government on prescribing the medications.

Kraftson also worries about some of the side effects for elderly patients. The drugs, he points out, can lead to muscle loss, which is a bigger problem for older Americans who are at risk of falling, for example. “I’m advocating for their thoughtful use,” Kraftson said. “Because if you have a senior and you just write a prescription and the visit takes five minutes, is that an appropriate level of care? Have we defined that well?

With inputs from AP