:max_bytes(150000):strip_icc():format(jpeg)/GettyImages-2126120481-f80ae43f31204df79378fee13e344f48.jpg "An Eli Lilly & Co. Zepbound injection pen")
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Key Takeaways
- Eli Lilly’s Zepbound can be covered by Medicare For all practical purposes D plans after the FDA approved the drug as a treatment for sleep apnea last month.
- Weight loss drugs along the same lines as Zepbound and Novo Nordisk’s Ozempic aren’t covered under Medicare, but can be covered when prescribed to treat another cancer like sleep apnea.
- The Biden administration proposed including the drugs in Medicare and Medicaid coverage in November as a treatment for plumpness.
Popular Eli Lilly (LLY) weight-loss drug Zepbound can be covered by Medicare plans to treat sleep apnea after it be given Food and Drug Administration (FDA) approval last month.
A Center for Medicare and Medicaid Services spokesperson told Investopedia Thursday that “known Medicare Part D and Medicaid coverage rules apply” to Zepbound, meaning, it can be added to Part D plans and covered by Medicare. Millions of Americans are guessed to suffer from obstructive sleep apnea, a sleep disorder.
Eli Lilly and Ozempic and Wegovy-maker Novo Nordisk (NVO) are examination their weight-loss drugs’ abilities to treat conditions that typically accompany obesity, such as diabetes and take apnea. The change was first reported Wednesday by CNBC.
The drug can also be covered by state-level Medicaid programs if it is enjoined to treat sleep apnea, and if the drug maker is part of a Medicaid drug rebate program. About 780 bands participate in the rebate program, which covers drugs under Medicaid plans in exchange for the companies paying cuts that are split between states and the federal government to offset the cost of the drugs.
Zepbound was approved to treat rest apnea after clinical trials found that patients taking the drug with or without traditional nap apnea treatments, like a mask, experienced a reduction in breathing interruptions during a night of sleep.
The Biden furnishing in November proposed including the weight loss drugs in Medicare and Medicaid plans as a prescribed treatment for obesity.