As part of the “most favored nation” (MFN) drug pricing deal the Trump administration signed with obesity giants Eli Lilly and Novo Nordisk, Medicare recently launched a “bridge” model, offering weight loss drugs to eligible seniors at $50 per month. Now, we know the initial uptake from the program.
Since the launch of the Medicare GLP-1 Bridge on July 1, over 500,000 seniors have utilized the program and together saved $216 million on those medicines, the White House said on Aug. 31 as it signed a new round of MFN deals with nine midsize biopharma companies.
During a separate press conference at the White House on Monday, Centers for Medicare and Medicaid Services Administrator Mehmet Oz, M.D., said “600,000 seniors already, just in two months, have signed up to get these medications” on the Bridge program.
Crunching the numbers, Jefferies analyst Akash Tewari figured the uptake indicates annualized revenues around $1.5 billion to $1.8 billion across the Bridge program. For Lilly, which currently leads the obesity race, that could already mean $900 million to $1.2 billion in annualized sales, according to an Aug. 31 note by Tewari.
About 3.8 million Medicare beneficiaries are eligible for Bridge, according to an estimate from the health policy research organization KFF, cited by Tewari.
At the current run rate, the Bridge program would reach a 25% penetration rate among eligible patients within the next one or two months, Tewari said, adding that he expects the growth might slow down later.
The GLP-1 makers are offering their weight-loss drugs to CMS at a net price of $245 per month, which Tewari used to reach the annualized sales number.
The Jefferies analyst acknowledged that adherence remains uncertain. But using the $216 million total savings number provided by the White House and the 600,000 sign-ups provided by Oz, Tewari calculated roughly 1.85 script fills per person during the past two months, which he said suggests “strong initial adherence and conversion.”
However, the implied number of fills would meaningfully decrease if the White House’s benchmark price was not $245 per month but $350 a month as offered on TrumpRx, a federal direct-to-consumer platform; after all, the $245 is being offered to the government, not to the patients themselves.
The Trump administration didn’t break down the Bridge program’s share split between Lilly and Novo. In the broader U.S. obesity market, Lilly has maintained a roughly 60% share thanks to its Zepbound. This is in spite of the slow launch of its oral Foundayo and fast growth of Novo’s Wegovy pill, according to Fierce’s Oral GLP-1 Tracker, based on IQIVA data.
Following Bridge’s launch on July 1, Wegovy’s total prescriptions, including both the original injectable and the new oral option, have been relatively flat so far. That gives Tewari more confidence in applying the same market share for Lilly to Bridge patients.
The encouraging initial uptake may represent only the tip of the Bridge opportunity, Tewari added. Compared with KFF’s 3.8 million estimate, Lilly’s more bullish estimate has put the eligible Medicare patient population at 20 million.
With Medicare Bridge, “35% more people now have coverage for our obesity medicines in the United States,” Lilly CEO David Ricks said on the company’s second-quarter earnings call last month.
To Tewari, the real market potential likely lies “somewhere in between.”