When President Trump and Centers for Medicare and Medicaid Services Administrator Mehmet Oz announced the creation of the GLP-1 Bridge Program last year, many Americans might have thought the administration had cut a deal that would drop the price of GLP-1 medications to $50 per month for anyone looking to lose weight.
In reality, the $50 co-pay applies only to Medicare patients, with taxpayers subsidizing the remaining $245 negotiated cost. Those on commercial insurance plans, employer-sponsored plans and most Medicaid programs were not included in the deal the federal government signed with Eli Lilly and Novo Nordisk.
Even with Medicare, not everyone qualifies. To qualify, one must have a BMI of 27 or higher with a metabolic risk factor; a BMI of 30 or higher with kidney disease, heart failure or uncontrolled blood pressure; or a BMI of 35 or higher regardless of other conditions. In other words, not everyone on Medicare and who gets prescribed a GLP-1 by their doctor will automatically qualify for the $50-per-month co-pay.
The bridge, it turns out, is quite narrow. The vast majority of Americans who want or need GLP-1 medications won’t qualify for the $50 price they expected.
All of this shows that government subsidies are not the answer to lowering GLP-1 medication costs. The GLP-1 Bridge Program will benefit a small subset of Americans in need, but to bring prices down for everyone, we need real healthcare reforms coupled with simple market solutions.