The Trump administration’s plan to offer discounted weight loss drugs to seniors through a Medicare pilot program has been abandoned after insurers refused to participate. Instead, the government will now cover these medications outside the Medicare Part D drug benefit.
Last year, the administration negotiated a deal with Eli Lilly and Novo Nordisk to lower the prices of their obesity drugs in exchange for expanded access in Medicare and Medicaid. While Medicare is legally barred from covering weight loss drugs, the administration proposed waiving this restriction to test whether the medications could reduce costs or improve health outcomes without additional spending.
The proposed pilot program, named BALANCE, required insurer participation despite potential financial strain. Under the agreement, drugmakers agreed to sell the treatments for $245 per month in Medicare and Medicaid, with beneficiaries paying only $50 per month.
The insurers’ refusal to join the pilot has forced the government to pursue an alternative approach to ensure access to these discounted weight loss drugs for seniors.
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