Novo Nordisk increases lobbying to seek Medicare coverage for obesity drugs

Novo Nordisk, maker of the weight-loss drug Wegovy and the diabetes drug Ozempic, is lobbying federal spending in the first six months of 2023.

The Danish drugmaker is pushing Congress to pass a bill that would remove Medicare’s restrictions on covering weight management care.

Novo Nordisk has recruited three new lobbying firms over the last three months, all of which it disclosed are focused solely on issues related to obesity and Medicare’s coverage of anti-obesity drugs.

A 2003 law excluded weight-loss drugs from coverage of Medicare, the federal program that provides health coverage for older Americans. But since the American Medical Association recognized obesity as a disease in 2013, momentum has built to change federal policy.

“When Congress created Medicare Part D drug benefits in 2003, the medical community’s understanding of obesity was still in its infancy,” Nicole Ferreira, senior manager of corporate communications at Novo Nordisk, told The Hill in a written statement.

“Since then, science has advanced, and we have learned that obesity is a chronic, treatable disease – not just a behavioral problem,” Ferreira wrote.

Senators Tom Carper (D-Del.) and Bill Cassidy (R-La.) and Representatives Raul Ruiz (D-Calif.) and Brad Wenstrup (R-Ohio) reintroduced the Treat and Reduce Obesity Act, which will broaden coverage weight management treatment to eligible Medicare beneficiaries, before the August recess.

Novo Nordisk lobbied

Although the Treat and Reduce Obesity Act has stalled every time it was reinstated over the past decade, drug makers are leveraging several new factors to defend their case.

Public demand for this weight loss drug is high and early clinical trials have recently shown that Wegovy reduces the risk of serious heart problems.

Eligible federal employees are now also eligible for anti-obesity medication coverage, the US Office of Personnel Management clarified in January.

“We recognize the progress made in covering anti-obesity treatment; our goal is for all Operators to offer adequate coverage,” reads the guide.

From January to June 2023, Novo Nordisk spent nearly $2.9 million lobbying federally for a variety of policy issues including obesity drug coverage and the Treat and Reduce Obesity Act, according to federal lobbying data analyzed by money in politics group OpenSecrets.

There are more lobbyists on Novo Nordisk’s payroll.

Sixty-three lobbyists, 44 of whom have passed through the so-called “revolving door” between the private and government sectors, signed up to lobby on behalf of the drugmaker in the first half of 2023, according to OpenSecrets data.

Novo Nordisk has a total of 50 lobbyists in 2022 and 28 in 2019.

Since late June, two new lobbying firms have registered three new lobbyists to work on obesity-related issues on behalf of Novo Nordisk.

One of the new lobbyists is Bill Ghent, a member of Subject Matters’ government relations team and former chief of staff of Carper, the bill’s main sponsor. Ghent was Carper’s legislative director when senators first introduced the bill in 2012.

Ghent did not return The Hill’s request for comment.

Shortages and cost concerns could derail momentum

Questions about cost and supply constraints clouded the hype around these new drugs.

This demand not only makes it difficult for people to access anti-obesity drugs, but also for diabetes patients to access the drugs they need.

Wegovy and Ozempic are both injectables that contain semaglutide, although the dosage per pen and regulatory-approved use differentiates the drugs.

The Food and Drug Administration (FDA) approved Ozempic to treat type 2 diabetes in 2017 and higher doses of Wegovy for weight loss in 2021.

Although Ozempic has not been approved for weight loss, it is sometimes prescribed off-label — meaning for purposes other than those approved by the FDA — as demand for the weight loss drug soars. However, off-label use is often not covered by insurance companies.

Demand for the drug is also outstripping supply, so the FDA noted that Wegovy and Ozempic’s semaglutide injections are “currently in short supply.”

“We understand how frustrating this situation is for the communities we serve and appreciate everyone’s patience as we continue to meet the significant demands placed on Wegovy,” said Ferreira.

“Please note that our commitment to the obesity community is long-term and we are investing significantly to build capacity to meet this increasing demand.”

Can Medicare coverage help with pricing?

It’s not clear how expanding Medicare coverage will impact the already high demand.

There is also ongoing debate about the cost of covering anti-obesity medication, as the Congressional Budget Office has yet to formally pass Treat and Reduce Obesity legislation.

Researchers at Vanderbilt University Medical Center estimate that providing a new anti-obesity drug to just 10 percent of Medicare beneficiaries could cost federal programs up to $26.8 billion annually and increase premiums for treatment plans.

But a study by the USC Schaeffer Center for Health Policy and Economics found that Medicare coverage for the treatment of obesity could result in savings of up to $245 billion in the first 10 years, due in part to reduced obesity-related co-morbidities, including heart attacks and strokes. .

“We have to talk about things that are black and white, because it’s not covering it up at all or giving it to everybody, and I think there’s a middle ground,” Alison Sexton Ward, a research scientist with a doctorate in applied economics who worked on the study. , told The Hill in an interview.

“A lot of talk is lost because of list prices,” Ward added.

Wegovy is very expensive without insurance, with a list price of up to $1,300 per month. While most patients are unwilling to pay full price after rebate or insurance, prices in the US are 10 times higher than in other countries, according to a recent analysis by KFF.

There are also many discounts that only apply to users who really have diabetes.

“Novo Nordisk believes that the most effective way for the millions of Americans who need anti-obesity drugs to access and buy them is to ensure they are covered by government and commercial insurance plans,” Ferreira said.

Health trade groups support the bill

A constellation of organizations including the American Diabetes Association (ADA), Weight Watchers and the Obesity Action Coalition are supporting the bill.

“The ADA urges Congress to pass this law quickly so that older Americans can access services and treatment to reduce their risk of obesity and diabetes and improve their health,” said Lisa Murdock, ADA’s chief advocacy officer, in a written statement.

The National Kidney Foundation, the American Gastroenterological Association (AGA) and the Academy of Nutrition and Dietetics are among supporters of the bill who reported lobbying efforts against the bill during the first half of 2023, ahead of the bill’s re-enactment.

“As many private insurers model their health benefits to reflect Medicare, bipartisan TROA endorsement could lead to increased obesity treatment options for all Americans,” Dr. Rotonya Carr, chairman of the AGA’s Committee on Government Affairs, told The Hill in an interview. written statement.

“The AGA fully supports this legislation and has no objection to extending the scope of obesity care to the millions of Americans suffering from obesity and its complications,” Carr wrote.

Notably, the pharmaceutical industry association PhRMA has yet to take a stand or lobby on the bill.

“We appreciate the focus on helping the elderly access the medicines they need. As treatment paradigms for diseases and conditions advance, it’s important to ensure Medicare coverage policies evolve as well,” PhRMA spokesperson Nicole Longo told The Hill.