When Medicare opened the door to cover Wegovy for heart disease last year, something remarkable happened: prescriptions through the program jumped by nearly six times in just six months.
Before March 2024, Medicare was barred from paying for weight-loss drugs. But after the Food and Drug Administration (FDA) approved Wegovy for reducing heart risks in people with obesity and heart disease, Medicare told insurance plans they could start covering it. A new study from the USC Schaeffer Center for Health Policy & Economics found that Medicare prescriptions for Wegovy surged 598 percent in the six months that followed.
The spike was far larger than growth seen with other Wegovy sales, suggesting the new heart-disease approval unlocked real demand. Across all types of insurance — Medicare, Medicaid, private plans, and even people paying out of pocket — Wegovy fills rose 136 percent. That translated to roughly 593,000 additional prescriptions nationwide.
The numbers look striking. But here's the catch: even with that growth, less than 1 percent of the roughly 3.6 million Medicare beneficiaries thought to qualify had actually picked up their prescription by the six-month mark. Researchers pointed to several likely reasons. The drug carries a high price tag, so some patients may have struggled with costs even with insurance. Insurance plans themselves may have been slow to add it to their lists of covered medicines. And some doctors may not have known the rules had changed.
"Although our study shows that federal policy change can help increase access to GLP-1s for heart disease, we still have a long way to go to ensure that patients can access and afford these medications as their clinical indications keep expanding," said Christopher Scannell, the study's lead author and a researcher at the USC Mann School of Pharmacy and Pharmaceutical Sciences.
GLP-1s are a class of drugs that were first approved for type 2 diabetes. Wegovy uses semaglutide, the same active ingredient found in the diabetes drug Ozempic. Since then, regulators have approved Wegovy for other conditions too, including a serious liver disease called MASH.
Medicare is now trying to expand access further through a temporary pilot program called Medicare GLP-1 Bridge, launched this month. But the program is set to expire in 2027, and insurance companies have resisted longer-term coverage over cost concerns.
Still, experts say the 598 percent jump proves that policy changes can quickly reshape who gets access to these medications — and that more changes could follow.