CMS: Step Therapy, Quantity Limits Can Be Used In Wegovy Heart Disease Coverage

By Luke Zarzecki / March 27, 2024 at 4:15 PM

FDA’s recent approval of Novo Nordisk’s Wegovy for cardiovascular treatment quickly paved the way for CMS coverage of the expensive weight-loss drug for the new indication, but CMS also told Medicare and Medicaid plans they can limit their costs by imposing prior authorization, step therapy and quantity limits -- and how Medicaid agencies will approach coverage is currently being decided by each state.


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