Weight Loss Drugmakers Fall on Insurer Concerns Over Medicare Coverage -- WSJ

Dow Jones04-22 04:05

By Peter Loftus

Shares of Eli Lilly and Novo Nordisk slipped after UnitedHealth said it had concerns about the Medicare payment model that aims to expand seniors' access to GLP-1 drugs for weight loss.

Shares of Lilly closed down 1.8%, while U.S.-traded shares of Novo Nordisk fell 2.6%.

The model is due to take effect next year, but only if Medicare drug plans that include about 80% of the program's enrollees opt to participate. UnitedHealth, the largest Medicare insurer, would be a key player, so its decision will be closely watched.

During UnitedHealth's earnings call, executive Bobby Hunter, who oversees government programs for the insurance arm of the company, said UnitedHealth has been talking to the Medicare agency about the program, and would "like to find a path to yes." But he said there were "notable challenges and outstanding questions with the currently planned structure." UnitedHealth has provided recommendations about how to change the demo, he said.

Both Lilly and Novo Nordisk are counting on Medicare coverage to boost sales of their weight-loss drugs including Zepbound and Wegovy. Previously, Medicare Part D plans have been barred from covering weight-loss drugs, which means seniors who want to take them have had to pay several hundred dollars per month out of pocket.

In deals with the Trump administration late last year, both Lilly and Novo Nordisk agreed to provide their weight-loss drugs at a discounted price for Medicare, with eligible beneficiaries paying a $50 monthly copay. The companies expect the Medicare coverage expansion, if it takes effect, will increase the volume of prescriptions, helping to offset the price discounts.

This item is part of a Wall Street Journal live coverage event. The full stream can be found by searching P/WSJL (WSJ Live Coverage).

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April 21, 2026 16:05 ET (20:05 GMT)

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