Takeaways on Medicare coverage of obesity drugs

Axios Pro hosted Sens. Tom Carper and Bill Cassidy on Tuesday for a discussion about whether Medicare should pay for blockbuster anti-obesity drugs like Wegovy and Zepbound.

Why it matters: The senators are sponsors of the Treat and Reduce Obesity Act, or TROA, which would lift a prohibition on Medicare Part D plans from covering weight-loss drugs.

Driving the news: The pair expressed concern about how the GLP-1 drugs, some of which can cost more than $1,000 a month, could weigh on Medicare's finances, but pointed to the many health benefits from treating obesity.

• "Doing nothing costs money ... we have to find out what works and what is cost-effective," Carper said.

Cassidy, the top Republican on the HELP Committee, was open to Chairman Bernie Sanders' push to question the CEO of Novo Nordisk about the cost of Wegovy and Ozempic in the U.S.

• "I think it is a valid interest for Congress to look at the cost of drugs here, that's that," said Cassidy. "We should hear from them and see what is their decision making process."
• "It may end up being 'well this is our fiduciary responsibility,' but that's kind of the argument that Martin Shkreli made," he continued. "There's also a social contract here, where you also have to make drugs affordable and for that we give you certain privileges. There is that tension and we need to hear how they're working to resolve that tension."
• Carper said he's hoping for Senate Finance or HELP to hold a hearing on TROA before he retires at the end of this Congress to "really look at the issue." House Ways and Means is planning a mark up of TROA sometime this summer, per lobbyist sources.

Catch up quick: Carper and Cassidy co-sponsored the first version of TROA in 2013, when Cassidy served in the House.

• The explosive growth in demand for GLP-1s has refocused attention on the legislation, especially since Medicare is starting to cover the injectables for other purposes like reducing the risk of cardiovascular disease.

Yes, but: Congressional scorekeepers haven't weighed in yet on TROA. CBO Director Phillip Swagel has noted that at current prices, anti-obesity drugs "would cost the federal government more than it would save from reducing other health care spending" and swell the deficit over a decade.

One fun thing: Carper, a theater buff, said the best Broadway play he's seen recently is Hell's Kitchen, featuring Alicia Keys' music.

• Cassidy, one of the organizers of the annual Seersucker Day on the Hill, said he owns just one of the suits and praised like-attired colleagues who know "how you empower somebody to look the absolute best in a hot Washington D.C. summer."