Insurers Reject Medicare Pilot for Weight‑Loss Drugs
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- Trump administration launched the BALANCE pilot to offer seniors obesity drugs at $245 per month with a $50 copay, testing cost‑saving health outcomes.
- Eli Lilly (with Novo Nordisk) agreed to sell its obesity drugs at $245 a month to Medicare and Medicaid.
- Insurers declined to join the pilot, citing a potential financial drain, so the government will cover the drugs outside Medicare Part D.
- Medicare will now provide the drugs via a non‑Part D mechanism, bypassing the pilot’s original design.
Why it matters: Insurers dodge a $245‑monthly price tag for obesity drugs, while Medicare must now fund the treatments outside Part D, raising administrative complexity and weakening the administration’s effort to test cost‑saving health outcomes.
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