Semaglutide for cardiovascular disease

[searcher]

Medicare to cover semaglutide for CV prevention for adults with overweight and obesity​

Key takeaways:​

• The FDA approved once-weekly semaglutide 2.4 mg to reduce CV risk for adults with obesity and preexisting CVD.
• Semaglutide can be covered in Medicare Part D plans specifically to treat the new CV indication.

Medicare Part D plans can begin to cover semaglutide to lower risk for cardiovascular events among adults with overweight or obesity and preexisting CVD, according to new guidance from CMS.

Section 1860D-2(e)(2) of the Social Security Act prohibits medications used for anorexia, weight loss or weight gain from being covered under Medicare Part D, according to an emailed statement to Healio from a CMS spokesperson. However, as Healio previously reported, the FDA approved a new indication for semaglutide 2.4 mg (Wegovy, Novo Nordisk), on March 8 to reduce risk for major adverse CV events for adults with overweight or obesity and established CVD. Section 1927(k)(6) of the Social Security Act states an obesity medication can be considered a Part D drug if it receives an additional medically accepted indication, according to the email from CMS. Semaglutide’s expanded indication for lowering risk for major adverse CV events permits it to be covered specifically for that use.

More:

https://www.healio.com/news/endocrinology/20240322/medicare-to-cover-semaglutide-for-cv-prevention-for-adults-with-overweight-and-obesity?utm_source=selligent&utm_medium=email&utm_campaign=news&fbclid=IwAR3kzkZ-ohkxl_elM0AYE0dman6qMpIC7yIYx8GNdhVULZgKR0xQUTosUtc