Medicare Part D spending on 10 diabetes drugs reached $35.8 billion in 2023, a 364% increase from 2019 at $7.7 billion, according to a February report from the Office of Inspector General (OIG).
At the same time, Medicare Part D enrollment has increased 12% to 50.5 million enrollees in 2023 from 44.9 million in 2019, the report showed.
For the report, the OIG selected 10 common type 2 diabetes drugs and analyzed trends in spending for these drugs, as well as trends in the number of enrollees prescribed these drugs. The drugs selected for the report include Mounjaro, Rybelsus, Ozempic, Trulicity, Bydureon, Victoza, Byetta, Invokana, Jardiance and Farxiga. Currently, Medicare Part D covers diabetes drugs for type 2 diabetes and cardiovascular disease but does not cover them for weight loss.
“Certain diabetes drugs initially approved by the Food and Drug Administration (FDA) to help control blood sugar levels for individuals with type 2 diabetes are known to be effective weight loss agents,” the OIG stated. “Prescriptions for and spending on diabetes drugs increased substantially in the last 5 years.”
The OIG also found that Medicare Part D spending for GLP-1 Ozempic increased by 1,567% to $9.2 billion in 2023 from $552 million in 2019. The number of Part D enrollees filling a prescription for Ozempic rose 929% to nearly 1.5 million in 2023, compared to over 142,000 in 2019.
By 2026, Medicare Part D spending on these 10 drugs is projected to reach $102 billion, the OIG noted.
“This substantial increase could have a financial impact on the Medicare program. Information in this data brief may be beneficial to CMS and other policymakers when developing future program guidance related to these drugs,” the OIG stated in the report.
The report comes after the Biden administration introduced a proposed rule in November that would cover GLP-1s for obesity under Medicare and Medicaid. However, it is unclear how the Trump administration will move forward with the proposed rule. In January, more than 70 organizations called on the Trump administration to finalize the rule. This includes the American Diabetes Association, the Obesity Action Coalition and the Society for Women’s Health Research.
The OIG said in the report that it “plans to conduct additional audits related to Medicare Part D utilization of and spending for select diabetes drugs to determine whether diabetes drugs were paid for in accordance with Federal requirements.”
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