Allowing Medicare to cover anti-obesity medications would drive up federal spending by about $35 billion on net between 2026 and 2034, according to a new report from the Congressional Budget Office (CBO).
The CBO estimates that total federal costs for covering these drugs would grow from $1.6 billion in 2026 to $7.1 billion in 2034. By comparison, savings from the use of these medications would be relatively limited, the study found, totaling less than $50 million in 2026 and about $1 billion in 2034.
The estimate is based on an "illustrative policy" that would extend Medicare coverage to these drugs beginning Jan. 1, 2026. The policy would authorize coverage for anti-obesity medications for all beneficiaries who are obese as well as some who would be classified as overweight.
CBO projects that 12.5 million Medicare beneficiaries would be able to receive an anti-obesity medication in 2026 if coverage were expanded. Though it estimates that only about 300,000, or 2%, of those eligible would take an anti-obesity medication product in 2026.
By 2034, CBO estimates that the number of eligible beneficiaries would decrease slightly to 11.9 million, with 1.6 million, or 14%, of those newly eligible taking the drugs.
The analysis found that savings related to weight loss for people who take anti-obesity medications are less than the costs associated with covering these products. CBO estimates that the feds would pay $5,600 per user on average in 2026, with that decreasing to $4,300 by 2034. However, it only projects $50 in savings per patient in 2026, a figure that grows to $650 for 2034.
The agency said in the report that it expects costs related to anti-obesity medications to decrease over time as the cost for the drugs themselves will likely decrease over time, leading to greater savings from their use in tandem.
"The budgetary effects of authorizing AOM coverage in Medicare are highly uncertain," the CBO researchers said in the report. "Estimates of costs and take-up rates are sensitive to the rapidly evolving evidence on the eligibility, use, price, and clinical benefits associated with those medications."
Obesity is a common chronic need among Medicare beneficiaries, CBO notes in the report, with more than two-thirds of people enrolled in Medicare either being obese or overweight.