Medicare Cost Impact of Semaglutide Under Voluntary Price Agreements

About The Study: This analysis suggests that the lower semaglutide price of $245 per month established under the Centers for Medicare & Medicaid Services (CMS) Innovation Center demonstration project—the Better Approaches to Lifestyle and Nutrition for Comprehensive Health (BALANCE) model could generate savings that would offset the cost of treating an additional 550,000 to 3.6 million Medicare beneficiaries eligible for expanded obesity-indication coverage, depending on assumptions about baseline use and further price reductions.

Corresponding Author: To contact the corresponding author, Stacie B. Dusetzina, PhD, email s.dusetzina@vanderbilt.edu.

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(doi:10.1001/jama.2026.2615)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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