Where are you getting $1700? You're right, there are cheaper alternatives. Novo is now offering Wegovy out of pocket for $500/month. Eli Lilly is offering Zepbound out of pocket, for $349 and $499/month, depending on dosage.
And truth is insurance plans never pay the list price for drugs, they pay a lower negotiated rate. So you can't look at a drug's list price and assume that's what Medicare would actually pay. It's more nuanced than that.
And last I checked, 11 or 12 state Medicaid programs already cover GLP1s.
Do you really think that they would give the discount to Medicare/Medicaid? They would pay billions of dollars to lobby congress to make sure they get full price. Can you tell me what states have allowed this? This is the first I'm hearing about it. I would like to look into it more and see what they charge.
Congress doesn't negotiate the prices of specific drugs. Congress wouldn't set pricing for Wegovy, that is CMS's job. Congress does have some influence on whether CMS has the authority to negotiate prices on any drugs, and CMS does the negotiations.
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u/Sea_shell2580 2d ago
Where are you getting $1700? You're right, there are cheaper alternatives. Novo is now offering Wegovy out of pocket for $500/month. Eli Lilly is offering Zepbound out of pocket, for $349 and $499/month, depending on dosage.
And truth is insurance plans never pay the list price for drugs, they pay a lower negotiated rate. So you can't look at a drug's list price and assume that's what Medicare would actually pay. It's more nuanced than that.
And last I checked, 11 or 12 state Medicaid programs already cover GLP1s.