Millions of older Americans are about to gain access to obesity drugs through Medicare for the first time, but most of them don't know it yet. Starting Wednesday, eligible beneficiaries can get obesity drugs through Medicare's new Bridge demonstration program for a monthly copay of just $50. The coverage marks a long-sought victory for patients, physicians, and obesity advocates who have pushed for broader access to the blockbuster treatments from Novo Nordisk and Eli Lilly, which have remained out of reach for many Americans.
According to CNBC, a staggering 82% of all older Americans say they are unaware that Medicare is about to begin covering obesity drugs. That figure includes 79% of Republicans and 84% of Democrats. The data comes from a survey released in early June by the Obesity Care Advocacy Network, conducted in late March among more than 2,100 adults ages 65 and older. The survey was completed weeks before the government announced it would extend the Bridge program through 2027.
Some physicians and other experts told CNBC they have noticed limited advertising of the new coverage to the general public from the Centers for Medicare and Medicaid Services, or from Novo and Lilly directly.
CMS has offered an explanation for the quiet rollout. An agency official told reporters on Thursday that beneficiaries are "most moved to take action" when a benefit is actually available to them, and that CMS will put out more promotions after the launch, "in the interest of being good stewards of our taxpayer dollars." Other experts also noted it may come down to making sure providers and pharmacies are prepared and resources are in place before pursuing broad public outreach.
Still, the low awareness numbers worry some medical professionals. Dr. Shauna Levy, medical director of the Tulane Bariatric and Weight Loss Center, said she has not seen much information circulating for patients. "I have not seen a lot of information out there for the public, and I think there are going to be plenty of people who have zero knowledge of the Bridge program," Levy said. "And I think for patients, it's just going to take even longer for them to find out about it, and then see if they're eligible."
The quiet lead-up stands in contrast to how Novo and Lilly have historically marketed their obesity and diabetes treatments, which have appeared in television commercials and subway advertisements. Novo spent nearly $500 million on U.S. advertising for its medicines in recent years.
Enrollment in the Bridge program is not automatic, which adds another layer of complication for seniors who do find out about it. Unlike traditional Medicare drug coverage, patients must meet eligibility requirements, obtain a prescription, and receive prior authorization approval through CMS before coverage begins. Experts say that process could slow down access even for seniors who are aware the program exists and want to participate.
The combination of low public awareness and a multi-step enrollment process raises concerns among some in the medical community that eligible seniors will not get onto these treatments as quickly as they could. The Bridge program is currently set to run through 2027, giving CMS time to assess how the coverage functions before potentially making it permanent.
