Cover GLP-1 drugs under Medicare and Medicaid affordably

OPINION:

The Trump administration is fighting a new front against America’s obesity epidemic, and not a moment too soon. Already, Health and Human Services Secretary Robert F. Kennedy Jr. has led his department with a “Make America Healthy Again” focus: healing our food supply and bringing commonsense regulation back to American medicine. It’s the kind of change that will pay dividends for years to come.

For some Americans, though, a holistic diet change isn’t enough. That’s why the Trump administration has signaled openness to covering GLP-1 drugs through government insurance programs.

For those struggling with obesity, we’re talking more than 100 million Americans, GLP-1 drugs offer hope. They work by mimicking hormones that regulate hunger, reducing cravings, slowing digestion and promoting sustained fullness. That regulation leads to weight loss, lowering rates of heart disease and diabetes in the process. The administration’s proposed program emerges as “an alternative way to get anti-obesity drugs to Medicare and Medicaid patients,” a recent Washington Post article said.

The initiative is set to launch in April for Medicaid and January 2027 for Medicare plans. It’s a timely move. Obesity is a public health crisis; beyond harming millions of Americans’ quality of life, it’s draining our economy and health care system. Increased coverage under this plan could get the ball rolling on healing Americans from the inside out.

This isn’t just about medicine, though. Under the proposed program, per the Center for Medicare & Medicaid Innovation, participating plans would be required to pair drug coverage with diet and exercise coaching, aiming for holistic improvements in metabolic health. It’s everything MAHA is all about. It blends the best of pharmaceutical innovation and lifestyle support to heal the problem, not just mask it.

Here’s the problem. For all the money that healing the obesity epidemic would save, GLP-1 drugs are incredibly costly. Brand names from Big Pharma such as Novo Nordisk and Eli Lilly can run thousands of dollars a month. That’s tens of thousands of dollars per year. Multiply that by the millions of eligible beneficiaries of the program, and the price tag will have taxpayers sweating.

Congress estimates that covering these drugs for obesity could cost Medicare alone $35 billion from 2026 to 2034. As David Rind, chief medical officer at the Institute for Clinical and Economic Review, told The Post: “In the aggregate, this is terrifying. I just don’t know how our nation is going to pay for this.”

Here’s where the administration has a golden opportunity to innovate further. Instead of relying solely on pricey brand-name drugs, incorporate compounded versions of GLP-1s as a safe, affordable alternative. What are compounded drugs? Custom prepared by licensed pharmacies for individual patients when commercially available drugs aren’t suitable, they may use the same active pharmaceutical ingredients.

However, compounded drugs are not approved by the Food and Drug Administration and have not been evaluated for safety or efficacy. Where brand-name options hover around $1,000 monthly, compounded versions are available for as little as $99 to $150 per month, according to providers such as Ivim Health. That’s a radical reduction, making coverage feasible without bankrupting taxpayers.

Of course, critics may raise safety flags, pointing to FDA warnings about unapproved or counterfeit versions. It’s true that the FDA has reported adverse events linked to poorly compounded GLP-1s, and professional societies such as the American Diabetes Association have echoed concerns.

This overlooks a key distinction. When sourced from licensed, FDA-regulated compounding pharmacies and prescribed under a doctor’s regular care, these alternatives are safe and effective. The compounding pharmacies operate under strict federal guidelines, including the Drug Quality and Security Act, ensuring sterile preparation and accurate formulation. Translation: You get the quality of the name brands without the price tag.

Imagine the savings. For the estimated 100 million obese Americans, even partial adoption could avert billions of dollars in long-term health care costs from obesity-related illnesses. The plan’s emphasis on pairing compounded drugs with mandatory lifestyle coaching prioritizes prevention and healthy lifestyle over lifelong medication. Under the regular guidance of a doctor, compounded drugs offer a more effective solution to a complicated problem.

The Trump administration’s experiment is a commendable step toward treating obesity as a chronic disease deserving of coverage, but to truly “Make America Healthy Again” without breaking the bank, let’s embrace compounded GLP-1s as a smart, cost-effective bridge. Policymakers should urge the FDA to permit their use in controlled settings, ensuring safety through oversight.

It’s a smart solution to a perennial problem. All Americans could have access to life-changing treatments, so let’s make it happen.

• Sean Spicer served as President Trump’s first White House press secretary and now hosts “The Sean Spicer Show.”