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Healthcare

Medicare's GLP-1 Bridge Opens the Door — Lilly Has the Bigger Key

CMS just opened Medicare Part D to Zepbound and Wegovy for the first time — but manufacturing capacity, not the policy itself, decides which company actually converts the new patient pool into revenue.

Image: Money Racket

By Evan at Money Racket · Apr 21, 2026

The lede: For three years, Medicare has been legally barred from paying for obesity drugs — Part D's statute explicitly excludes weight-loss agents. That wall just came down. Under the CMS Medicare GLP-1 Bridge, effective July 1, 2026 through December 31, 2027, Part D plans will cover Zepbound (KwikPen only) and Wegovy for beneficiaries with a BMI of 35+, or 30-34.99 with a qualifying comorbidity, at a $50 copay per 30-day supply. The deal came bundled with a most-favored-nation pricing agreement: injectables priced from $245/month, orals from $149/month, sold through the new TrumpRx platform. That's a huge new patient pool — tens of millions of Medicare beneficiaries meet the BMI threshold — but it doesn't convert into equal upside. Whoever can actually fill the pens wins the volume; whoever can't leaves the money on the table for compounders and competitors.

Who cashes in:

Discussion

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