A Budgetary Impact Analysis of Medicare Coverage for AntiObesity Interventions

Key Findings
 IHS Markit used a validated and published individual simulation model to predict the budget
impact to Medicare coverage utilization of anti-obesity interventions
 Over the next 10 years, Medicare is expected to save $19 billion after a modest coverage
utilization, and $21 billion after a more aggressive coverage utilization, with the majority of the
savings coming from reduction in ambulatory care (Part B) and prescription drug (Part D)
expenditures
 Even after an aggressive (67.4%) coverage utilization, the evidence shows ≤8% of all Medicare
beneficiaries to receive some form of anti-obesity treatment
 The analysis demonstrates on average, lifestyle intervention helps elderly who are eligible lose
7.5% of excessive weight per year, and anti-obesity drug combined with lifestyle intervention can
help eligible patients lose about 9.7%. Participants regain 1/3 of initial lost weight within 5 years
after discontinuation
 The data show that each treated beneficiary is expected to incur direct costs to Medicare of
~$1,700 from covered anti-obesity treatment. Those costs will be offset by improvement in their
overall health condition, leading to lower expenditures in ER, ambulatory care, inpatient stays,
and Rx, resulting in net savings between $6,700 – $7,100 over 10 years per person
 Model estimates across the entire Medicare population suggest medical expense would increase
about $120 per beneficiary due to higher coverage utilization. The reduction in the cost of
treating obesity complications would be more than enough to offset the increased expense,
leading to a net savings of between $300 – $330 per beneficiary over 10 years

Source: Budget Report

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