How to evaluate GLP-1s and Medicare costs? Here’s one idea
Published in STAT+
While GLP-1 drugs have generated excitement for their weight loss potential, the evidence supporting their cost-effectiveness remains limited. In a recent STAT byline, Premier’s Soumi Saha and Somaieh McMullen propose a new pathway to Medicare coverage of GLP-1 medications used for weight loss. Premier argues that instead of a blanket coverage decision, the Centers for Medicare & Medicaid Services (CMS) should launch a targeted value-based care (VBC) pilot. This model would test GLP-1 coverage for Medicare beneficiaries with obesity and high-cost chronic conditions, using shared savings incentives to align provider accountability with patient outcomes. The pilot would also help build a stronger evidence base by tracking real-world outcomes, such as weight loss maintenance and improvements in chronic disease markers.
Premier suggests that this approach could help CMS manage costs, improve care coordination, and make more informed decisions about future Medicare coverage — all while addressing the growing demand for GLP-1s in a fiscally responsible way.
