Novo Nordisk's Wegovy Gains Reimbursement Coverage in Germany and the U.S. for Cardiovascular Risk Reduction

Intelligent Finance and Economics News learned that the latest news shows that Germany's public health insurance plan can coverNovo Nordisk(NVO.US) The use of the weight-loss drug Wegovy in patients at risk of heart disease or stroke has significantly bolstered Novo Nordisk's efforts to convince governments worldwide of its broader medical benefits. In a guideline published online late Thursday, Germany’s Federal Joint Committee (G-BA), the health authority of Europe's largest national pharmaceuticals market, stated that restrictions preventing the German health insurance system from covering weight-loss drugs like Wegovy do not apply to other approved uses of the weekly injection. Additionally,The US Medicare prescription drug plan may also cover Wegovy for the treatment of heart disease.

Recently, it was reported that the U.S. Centers for Medicare and Medicaid Services stated in a declaration that it had informed Medicare Part D (prescription drug plans) that anti-obesity drugs approved for additional indications could be covered. Wegovy was approved by the U.S. Food and Drug Administration (FDA) on March 8 for use in cardiovascular disease.

The EU drug regulatory agency has been reviewing the broader use of the popular weight-loss drug Wegovy, including reducing the risk of stroke and heart attack, expanding on its previously approved use for treating obesity. Novo Nordisk has been working to broaden insurance coverage in Europe by demonstrating health benefits beyond weight loss.

In a similar ruling on Thursday, the U.S. agency overseeing the Medicare program for seniors also said that heart patients within its jurisdiction who take Wegovy could reduce their risk of heart attacks and strokes. The U.S. Medicare prescription drug program, managed by private insurers, currently does not cover medications for obesity treatment.

The EU's review was based on a trial named Select, which showed that for certain overweight individuals already suffering from severe cardiovascular diseases, the drug could reduce the risk of heart attacks, strokes, or death from heart disease by 20%.

G-BA Officially Confirms That Germany's Statutory Health Plans Do Not Cover Wegovy for Weight Loss, but Adds a Warning. The committee stated in its guidance: "If an application is made to expand the indication approval, it should be explicitly noted that the use of Wegovy to reduce the risk of cardiovascular events following prior cardiovascular disease... is not subject to restrictions."

The guidelines from G-BA and Medicare may have an impact beyond the use of Wegovy, as Novo Nordisk's competitorsEli Lilly(LLY.US) has also been conducting trials to demonstrate the additional health benefits of its highly effective weight-loss drug, Mounjaro (also known as tirzepatide).

G-BA is a committee composed of doctors, health insurance companies, and hospital representatives, playing a government-designated critical role in setting treatment standards and financial coverage.

Germany’s announcement that weight-loss drugs are lifestyle products that people need to pay for themselves has impacted the statutory health plans covering 90% of Germans. Many other European countries have also maintained a restrictive stance on coverage within their healthcare systems.

Surging demand for Wegovy and Ozempic, a diabetes drug with the same active ingredient, has more than doubled Novo Nordisk's share price in the past two years but left the company struggling to meet demand for weekly injections. Analysts say that for now, people are paying out of pocket for weight loss drugs, which has been the main driver of sales growth for Novo and Eli Lilly, but public sector insurers could underpin the longer-term momentum.

Editor: Guo Mingyu