Key Takeaways:
Medicare's new GLP-1 pilot program is drawing more patients to injectable obesity drugs than oral versions, contrary to industry expectations.
More than 200 Medicare patients received approval for injectable GLP-1 drugs in the first week of a new pilot program, doctors said, defying earlier projections that older patients would prefer pills.
"Hands down — these patients are asking for injections as they know they work and it has been so costly in the past," Dr. Sarah Ro, director of University of North Carolina Health's weight-management program, said.
The U.S. Centers for Medicare & Medicaid Services launched the 18-month trial program this month, opening access to Novo Nordisk's Wegovy and Eli Lilly's Zepbound and Foundayo as weight-loss treatment alone for a monthly cost of $50. Eight of 10 doctors interviewed by Reuters and three pharma sector analysts said many patients are opting for injectables, despite Novo's earlier research indicating Medicare beneficiaries preferred pills by a 2-to-1 ratio.
The preference for injectables reflects their stronger efficacy data. Injectable Zepbound helped patients lose more than 22% of their weight after 72 weeks in clinical trials, while Wegovy led to 15% weight loss after 68 weeks. Oral versions showed lower results: Wegovy's pill led to about 14% reduction over 64 weeks, and Lilly's Foundayo produced about 11% reduction over 72 weeks.
"A year ago if you'd asked me, I would have thought people would be jumping at the pill," RBC Capital Markets analyst Trung Huynh said. "But it turns out that for most people, it's all about efficacy."
Dr. Christina Nguyen of weight-loss clinic Knownwell in Atlanta said the clinic received approvals for about 200 patients nationwide in the first week. "We're getting several approvals every day, if the patient meets the criteria," she said.
A CMS spokesperson said the program's first weeks have been "positive" with most authorizations completed in under 12 hours. However, access has been uneven. Katie Smith, a Virginia retiree who asked her doctor to send a prescription on July 1, said she is still waiting to learn if she will be covered. The companies' direct-to-consumer prices range from $149 to $449 per month.
The process has been "cumbersome" for doctors, said Dr. Amanda Velazquez, director of obesity medicine at Cedars-Sinai's Center for Weight Management and Metabolic Health in Los Angeles. "This has required numerous hours and numerous clinical staff and clinicians to come together to make standardized protocols, order sets, and troubleshoot to try to get through the red tape to get access to GLP1RAs for our patients," she said.
The strong early uptake of injectables signals that efficacy, not convenience, is driving patient decisions in the Medicare population. For Novo Nordisk and Eli Lilly, the program represents a significant new revenue channel — millions of Americans aged 65 and older are expected to qualify. Investors will watch monthly enrollment figures and any adjustments to the program's formulary structure as key indicators of long-term demand.
This article is for informational purposes only and does not constitute investment advice.
