Insurance Coverage For Weight Loss Drugs - Elevance, CVS Health Become First To Extend Coverage To Novo Nordisk's Successful Wegovy For Certain Patients
Insurance Coverage For Weight Loss Drugs - Elevance, CVS Health Become First To Extend Coverage To Novo Nordisk's Successful Wegovy For Certain Patients
Some major U.S. health insurers, including CVS Health Inc (NYSE:CVS), Elevance Health Inc (NYSE:ELV), and Kaiser Permanente will start reimbursing for Novo Nordisk A/S's (NYSE:NVO) Wegovy, a popular anti-obesity drug, for specific individuals on Medicare who have heart-related conditions.
一些主要的美國健康保險公司，包括CVS Health Inc（紐約證券交易所代碼：CVS）、Elevance Health Inc（紐約證券交易所代碼：ELV）和凱澤永久，將開始爲患有心臟相關疾病的特定醫療保險人群報銷廣受歡迎的抗肥胖藥物諾和諾德A/S（紐約證券交易所代碼：NVO）Wegovy。
These insurers have committed to covering Wegovy for individuals meeting specific criteria, including those with cardiovascular disease and meeting body-weight standards under Medicare drug-benefit plans.
這些保險公司已承諾爲符合特定標準的個人提供Wegovy保險，包括患有心血管疾病和符合醫療保險藥物福利計劃體重標準的個人。
Additionally, Elevance Health has extended coverage to individuals insured by commercial plans.
此外，Elevance Health已將承保範圍擴大到商業計劃所保險的個人。
This move marks a significant shift as weight-loss drugs, including Wegovy, had previously been excluded from Medicare coverage due to U.S. legislation, and private health plans had been reluctant to reimburse them due to their high costs.
此舉標誌着重大轉變，因爲包括Wegovy在內的減肥藥物此前由於美國立法而被排除在醫療保險範圍之外，而且私人健康計劃由於成本高昂而不願報銷。
The decisions by these insurers aim to alleviate the financial burden on individuals who were previously paying over $1,000 out of pocket monthly due to lack of coverage, potentially increasing access to those unable or unwilling to bear the hefty expense.
這些保險公司的決定旨在減輕以前由於缺乏保險而每月自付超過1,000美元的個人的經濟負擔，這有可能增加那些無法或不願承擔巨額開支的人獲得的機會。
The broader coverage of Wegovy by these insurers may prompt other Medicare and commercial health plans to follow suit, the Wall Street Journal noted, potentially leading to a substantial increase in drug spending for insurers already grappling with escalating healthcare costs.
《華爾街日報》指出，這些保險公司對Wegovy的更廣泛覆蓋範圍可能會促使其他醫療保險和商業健康計劃效仿，這可能會導致已經在努力應對不斷上漲的醫療成本的保險公司的藥品支出大幅增加。
Wegovy, priced at around $1,349 per patient per month, presents a significant financial consideration for insurers.
Wegovy的價格約爲每位患者每月1349美元，是保險公司重要的財務考慮因素。
The insurers' decisions come following new guidance issued by the Centers for Medicare and Medicaid Services (CMS), permitting coverage of anti-obesity medications like Wegovy for additional medically accepted uses, such as reducing the risk of heart attacks and strokes in individuals with a history of heart disease and elevated body mass index.
保險公司的決定是根據醫療保險和醫療補助服務中心（CMS）發佈的新指導方針做出的，該指導方針允許將Wegovy等抗肥胖藥物用於其他醫學上可接受的用途，例如降低有心臟病史和體重指數升高的人心臟病發作和中風的風險。
Earlier this month, the FDA approved Wegovy for expanded use in obesity and cardiovascular disease management.
本月早些時候，美國食品藥品管理局批准Wegovy擴大在肥胖和心血管疾病管理中的使用。
In August 2023, Novo Nordisk released the headline results from the SELECT cardiovascular outcomes trial.
2023年8月，諾和諾德發佈了SELECT心血管療效試驗的主要結果。
The trial achieved its primary objective by demonstrating a statistically significant and superior reduction in MACE of 20% for people treated with semaglutide 2.4 mg compared to placebo.
該試驗實現了其主要目標，證明與安慰劑相比，接受2.4 mg索馬魯肽治療的受試者的MACE降低了20％，這在統計學上顯著且優異。
As coverage expands, Elevance Health's CarelonRx unit, responsible for managing pharmacy benefits, has approved Wegovy to reduce the risk of major cardiovascular events, with plans to roll out coverage to commercial and Medicare Part D plans.
隨着承保範圍的擴大，Elevance Health負責管理藥房福利的CarelonRX部門已批准Wegovy降低重大心血管事件的風險，並計劃爲商業和醫療保險D部分計劃提供保險。
Similarly, Kaiser Permanente and CVS Health have announced their plans to offer Part D coverage of Wegovy in alignment with CMS guidance, with Humana Inc (NYSE:HUM) reviewing the new guidelines.
同樣，凱澤永和CVS Health也宣佈計劃根據CMS的指導方針爲Wegovy提供D部分保險，Humana Inc（紐約證券交易所代碼：HUM）正在審查新的指南。
Price Action: NVO shares are up 0.83% at $129.11 on the last check Thursday.
價格走勢：在週四的最後一次支票中，NVO股價上漲0.83％，至129.11美元。
Disclaimer: This content was partially produced with the help of AI tools and was reviewed and published by Benzinga editors.
免責聲明： 該內容部分是在人工智能工具的幫助下製作的，並由Benzinga編輯審閱和發佈。
Image Via Shutterstock
圖片來自 Shutterstock
譯文內容由第三人軟體翻譯。