CMS Unveils Short-Term Cost Plunge of GLP-1 Weight-Loss Drugs for Older Americans  

SPECIAL BULLETIN Beyond “Inpatient” or “Observation:” Documenting the Why

For many older Americans, the weight may soon be over.

Starting this week, qualifying Medicare beneficiaries will be eligible to obtain certain weight-loss medications for $50 per month via the Medicare GLP-1 Bridge, a new Centers for Medicare & Medicaid Services (CMS) initiative intended to expand access to the drugs and test the concomitant impacts on the overall Medicare program.

“For too long, many Americans have been unable to access these treatments because of cost,” CMS Administrator Dr. Mehmet Oz said in a statement issued yesterday. “The Medicare GLP-1 Bridge creates a new pathway for eligible beneficiaries to afford GLP-1 medications. If you think a GLP-1 medication may be right for you, talk with your doctor and learn whether you qualify.”

But don’t wait – the program only runs through the end of next year.

A KFF study issued in November 2025 illustrated a glaring disparity in use of the medications between subsets of Americans over the age of 50. The study found that the age group with the highest adoption rate of GLP-1 drugs, 22 percent, was those 50-64, while only 9 percent of those 65 or older reported use – a direct result of Medicare’s previous lack of coverage, with costs for individuals often soaring to between $500 and $1,000 a month.

KFF’s study also found that while nearly 1 in 5 Americans overall reported having ever taken a GLP-1 drug (with 12 percent reporting current use), over half of them, 56 percent, described them as difficult to afford, with 27 rating it “very difficult.” Nearly half of those diagnosed with diabetes, 45 percent, reported current use.

The medications’ impact on both the American and global economies has been staggering, and is only recently becoming better understood. Morgan Stanley in April released a study showing that the market for the drugs – dominated by the Indianapolis-based Eli Lilly, makers of Mounjaro and Zepbound, along with the Danish firm Novo Nordisk, makers of Ozempic and Wegovy – sat at just $15 billion in 2024, grew to $79 billion in 2025, and could approach $200 billion by 2035.

“The GLP-1 category is approaching another important inflection point, driven mainly by the launch of oral therapies and the expansion of Medicare access in the U.S.,” a Morgan Stanley article quoted Terence Flynn, the leader of coverage of U.S. pharma and biotech industries for the company’s Research subdivision, as saying. “These new dynamics are likely to significantly expand adoption.”

Centering on American counties were GLP-1 adoption was known to have surged and analyzing associated credit-card data, Morgan Stanley found reduced rates of spending at fast-food restaurants, but moderately increased spending at full-service, sit-down restaurants, as consumers changed their spending and dining habits. The big winners? High-end gyms.

To qualify for the reduced Medicare cost, beneficiaries must have a body mass index (BMI) of 35 or higher – or a figure between 27 and 34.9, coupled with at least one specified obesity-associated health complications for a given individual’s height and weight.

For more information on the new CMS program, go to Medicare.gov/glp1bridge

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Mark Spivey

Mark Spivey is a national correspondent for RACmonitor.com, ICD10monitor.com, and Auditor Monitor who has been writing and editing material about the federal oversight of American healthcare for more than a decade.

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