Covering the Land of Lincoln

Seeking Medicare Coverage for Weight Loss Drugs, Pharma Giant Courts Black Influencers

Pharmaceutical giant Novo Nordisk has turned to influential Black Americans in pursuit of what would be a lucrative victory: having Medicare cover a new class of weight loss drugs, including the company’s highly sought Wegovy, which can cost patients more than $1,000 a month.

During a conference of the Congressional Black Caucus Foundation last fall — a jampacked gathering featuring prominent Black lawmakers and President Joe Biden — Novo Nordisk sponsored a panel discussion on obesity for which it selected the moderator and panelists, company spokesperson Nicole Ferreira said. The foundation is a nonprofit affiliated with the Congressional Black Caucus, a powerful group of lawmakers on Capitol Hill.

Former CNN political commentator Roland Martin moderated. Black health experts who support Medicare coverage of drugs used to treat obesity served on the panel. They included Fatima Cody Stanford, an associate professor of medicine at Harvard Medical School. Stanford is a specialist in obesity who has received consulting fees from Novo Nordisk.

During the panel discussion, Stanford told the audience that obesity “is a real disease that people struggle with,” she recounted in an interview with KFF Health News. “We’ve denied people care for obesity when we haven’t for other chronic diseases.”

Novo Nordisk, the leading maker of so-called obesity drugs, followed up on the September panel by sponsoring a streaming show in March hosted by Martin, during which guests advocated for Medicare to cover drugs for weight loss. Ferreira said the company suggested experts for the segment, but she did not name them.

Those activities are part of a broader Novo Nordisk campaign to shift the public narrative about obesity. They open a new window on drugmakers’ efforts to influence consumers and public policy.

Novo Nordisk is trying to reverse a 20-year-old ban on coverage of drugs used for weight loss under Medicare, the federal health insurance program primarily for people 65 and older. Congress excluded such medications when it established Medicare’s Part D prescription drug benefit in 2003. The ban effectively deprives drugmakers of millions of potential customers.

Expanding the Patient Pool

Medicare coverage would put obesity drugs within reach of many people who could not otherwise afford them. It could have a multiplier effect because private insurers often follow Medicare’s lead.

It would be a financial boon to Novo Nordisk and other drugmakers, including Eli Lilly, which is seeking FDA approval for a weight loss drug.

Adding to the cost, and the potential upside for the industry: To keep weight off, patients may have to take the drugs indefinitely.

Wegovy’s list price is about $1,350 for roughly a month’s supply. Eli Lilly’s Mounjaro, a drug for people with Type 2 diabetes that doctors prescribe off-label for obesity, is priced at about $1,023 for roughly a month’s supply.

Wegovy is FDA-approved for weight loss in adults who have a body mass index of 30 or greater — the definition of adult obesity, according to the Centers for Disease Control and Prevention — or a BMI of at least 27 plus at least one weight-related medical condition, such as hypertension. It’s also approved for patients as young as 12 who are deemed obese.

In a statement, Novo Nordisk spokesperson Allison Schneider said, “We advocate for patients and policies that support access to all obesity treatments, including coverage for anti-obesity medications in Medicare Part D.”

The company supports the Treat and Reduce Obesity Act, legislation introduced in 2013 that would overturn the Medicare coverage ban. In July, a bipartisan group of lawmakers in the House and Senate reintroduced the bill — something lawmakers have done repeatedly over the decade.

Drug companies have long used a variety of strategies to advance corporate interests, such as funding so-called patient advocacy groups focused on specific diseases and airing direct-to-consumer ads that spur patients to ask their doctors about brand-name drugs.

Novo Nordisk is the biggest corporate donor to the Obesity Action Coalition, which says its mission is “to elevate and empower those affected by obesity.”

Novo Nordisk contributes more than $500,000 annually to the group, according to its website. The group’s legislative objectives include reversing Medicare’s coverage ban on weight loss drugs.

The Obesity Action Coalition “is not influenced in any way by our vast array of supporters,” said Kendall Griffey, a spokesperson for the group.

Novo Nordisk has advertised Wegovy, which the FDA approved for weight loss in 2021, and Ozempic, which is approved for diabetes and prescribed off-label to treat obesity.

Like many large corporations, Novo Nordisk has contributed thousands of dollars annually to nonprofits tied to different groups of lawmakers while seeking support in Congress for its causes.

In 2021, Novo Nordisk gave between $100,000 and $399,999 to the Congressional Black Caucus Foundation and between $25,000 and $49,999 to the Asian Pacific American Institute for Congressional Studies, according to each nonprofit’s annual report.

The latter nonprofit, known as APAICS, is affiliated with the Congressional Asian Pacific American Caucus. APAICS lists Novo Nordisk as a partner on webpages for events in March and May where panel discussions touched on the treatment of obesity.

The Congressional Hispanic Caucus Institute also lists Novo Nordisk as a donor but doesn’t state how much the company contributed.

The Congressional Black Caucus, Congressional Hispanic Caucus, and Congressional Asian Pacific American Caucus back a bill on health disparities that in 2022 was revised to scrap Medicare’s prohibition on covering prescriptions for weight loss.

The Congressional Black Caucus Foundation, the Congressional Hispanic Caucus Institute, and the Asian Pacific American Institute for Congressional Studies did not respond to questions for this article. Novo Nordisk declined to say how much it contributed to the Congressional Black Caucus Foundation’s 2022 legislative conference and whether it sponsored the panel to influence Congressional Black Caucus members’ positions; it similarly declined to specify its most recent annual contribution to the Congressional Hispanic Caucus Institute and its financial contributions for various APAICS events this year. “We support multiple organizations to help educate on and highlight issues important to their communities,” company spokesperson Natalia Salomao said of Novo Nordisk’s relationship with the nonprofits.

High-Profile Promoters

Martin’s streaming daily news show in March featured an hourlong segment “powered by Novo Nordisk” on obesity among Black Americans. Ferreira, of Novo Nordisk, said Martin and Novo Nordisk “agreed that a segment on his show was a good opportunity to reach his audience to help further inform them about obesity as a chronic disease and the importance of good nutrition and health care.”

Martin did not respond to requests for comment. During the episode, he cited Novo Nordisk’s role. “I certainly want to thank them for partnering with us,” he said.

Guests pushed for Medicare to cover patients’ anti-obesity prescriptions, with an eye toward what coverage could mean for seniors and other adults. The federal government is “supposed to be leading the way on this,” Nelson Dunlap, vice president of public policy and external affairs for Meharry Medical College, a historically Black institution, said during the segment.

“Commercial insurances tend to follow what Medicare does,” Tiffani Bell Washington, a psychiatrist specializing in obesity medicine, said on the show. Obesity is “a health issue. So it really does need to be covered, and if Medicare covers it, usually other people follow.”

Dunlap declined to comment for this article, and Bell Washington did not answer questions sent by email.

Novo Nordisk enlisted Black music and entertainment stars Queen Latifah and Yvette Nicole Brown to be paid spokespeople for an educational campaign that began in 2021 communicating that obesity is a chronic disease and should be treated like other ailments. Both celebrities have openly talked about living with obesity.

Stanford, one of the participants in the September panel, in 2022 received $23,188 from Novo Nordisk, nearly double what she received from the company in 2021, federal records show. The 2022 payments include consulting fees and expenses for meals and travel.

“I wouldn’t want someone that has no knowledge informing them on how this actually works in real life,” Stanford said, explaining her relationship with the companies. “The people they learn from are people like me, the people that actually do this work on the ground every day with patients.”

Another panelist was Eric Griggs, an assistant vice president at Access Health Louisiana, a network of federally qualified health centers. In an interview, Griggs said Medicare coverage of obesity drugs “would help the solution. If you can help one group, you can help them all.”

According to the Centers for Disease Control and Prevention, based on BMI, 50% of non-Hispanic Black adults in the U.S. are classified as obese, the highest rate for any race or ethnicity.

However, the BMI measurement has increasingly come under criticism as flawed. In June, the American Medical Association said it “does not account for differences across race/ethnic groups, sexes, genders, and age-span.”

Since 2014, Novo Nordisk has spent more than $30 million lobbying members of Congress and other federal officials, according to a KFF Health News review of lobbying disclosures. A consistent subject is the Treat and Reduce Obesity Act.

“We have enormous health care challenges that flow from obesity,” said Sen. Tom Carper (D-Del.), a lead sponsor of that legislation. He argued that spending money on weight loss drugs would reduce spending on chronic diseases that drive up the federal government’s health care tab.

Carper is a longtime recipient of campaign cash from drug companies, including makers of weight loss drugs. However, some researchers express caution about lifting Medicare’s coverage ban. For seniors, the side effects of such drugs could be more dangerous, according to a paper by scholars  at Vanderbilt University and the University of Chicago.

Side effects for Wegovy and Ozempic may include kidney problems, gallbladder disease, inflammation of the pancreas, and thyroid cancer, according to the product labels. Suicidal thoughts are listed as a potentially serious side effect of Wegovy, its label says.

The Vanderbilt and Chicago researchers found that, even with modest uptake of the medications, annual Medicare Part D expenses could increase by $13.6 billion. That could leave policymakers “in the position of making broad cuts to other types of care,” said Khrysta Baig, one of the paper’s authors.

But people who want Medicare and other insurance programs to cover the drugs emphasize potential advantages.

Coverage would save “the lives that we’re losing at early ages, especially in the Black community,” Bell Washington said on Martin’s show in March, before calling on viewers to take action. “You need to write to your legislators, make sure you’re choosing people who are in support of health care for all,” she said.

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