72. Fetterman Is Right On GLP-1s, But Now Is Not The Time To Expand In Medicare
Release Date: 04/25/2025
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info_outlineAbout The Podcast:
Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.
Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.
Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.
Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.
Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.
About The Episode:
On this episode, Marc discusses how Sen. John Fetterman wants the Trump administration to change its mind and extend further GLP-1 weight-loss coverage in Medicare Part D. But now is not the time.
Key Takeaways:
Sen. John Fetterman was much-maligned during his 2022 Senate run but has emerged as a thoughtful and sober senator.
In a recent opinion piece in The New York Times, Fetterman urges the Trump administration to reconsider and expand GLP-1 access in Medicare.
The Biden administration had proposed expanding GLP-1 access to those with obesity. Now it is only available for those with another underlying disease state like diabetes or cardiovascular disease.
Both Fetterman and I are on the same drug and he is right that being on a GLP-1 can transform your life.
As he says, it does promise to reduce chronic disease costs in the future.
The problem with expansion is that costs for such drugs are surging already for disease states alone and adding obesity as a diagnosis would accelerate that.
Already, Medicare Advantage (MA) and the standalone Part D (PDP) program saw huge cost surges because of an unwise Part D cost-sharing reduction in the Inflation Reduction Act (IRA). The PDP program’s financial viability is precarious.
Drug price negotiations may help but a 22% average reduction as we have seen will not be enough.
We should wait to expand GLP-1 coverage in Medicare until prices come down dramatically for these drugs and more analysis can be done.
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