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Medicare/Medicaid does not currently cover weight loss drugs by fontoknow
That could obviously change.
For those with insurance that covers, very few individuals are paying close to list price for this class of drugs. As more types of these drugs make it through clinical trials and/or approved for weight loss, we should see competition bring down the price.
Economists that looked at the cost-effectiveness of these drugs have indicated that health savings for treating obesity related issues are greater than the cost of the treat for most when looking at net price (co-pay plus negotiated payment to PBM for the treatment). Competition and transparency will help this.