彭博Bloomberg·2025-12-10 06:04Core Viewpoint - The article discusses the potential sales loss of $2 billion to $3 billion for Novo Nordisk and Eli Lilly's GLP-1 obesity drugs due to a new agreement with the White House, which will lower drug prices and expand Medicare coverage [3][10]. Group 1: Sales Impact and Market Predictions - The combined sales of GLP-1 obesity drugs in the U.S. market are expected to decrease to $26.4 billion in 2026, which is 6% lower than market expectations [3]. - The price reduction of 25%-35% for GLP-1 drugs will be implemented as Medicare expands coverage to an additional 10 million eligible patients [3][9]. - The estimated sales for GLP-1 drugs in 2026, prior to the new pricing, was projected to reach $29.4 billion, but this may need to be adjusted downwards by $2 billion to $3 billion due to the new pricing structure [10][11]. Group 2: Medicare Coverage Details - The Medicare obesity pilot program is set to launch in Spring 2026, initially as a pilot and potentially becoming mandatory in 2027 [4]. - Medicare will procure Novo Nordisk's Wegovy and Eli Lilly's Zepbound at a price of $245 per patient per month, with patients responsible for a $50 copayment [4][5]. - The proposed eligibility criteria for Medicare coverage will include individuals who are overweight with a BMI over 27, those with prediabetes or cardiovascular disease, and those with a BMI over 35 [4][5]. Group 3: Medicaid Coverage Variability - Medicaid will also procure GLP-1 drugs at the same price of $245 per patient per month, but states have the option to choose whether to participate [9]. - Currently, 12 states cover GLP-1 drugs for obesity, but California will exit the program due to budget constraints [9]. - If all states were to adopt the coverage, the number of eligible patients under Medicaid could reach up to 4.5 million, although this is considered unlikely [9].