KFF projects Medicare GLP-1 Bridge costs of $1.3 billion to $10 billion
An outside estimate puts the 18-month price tag for Medicare's $50-a-month obesity drug program at $1.3 billion to $10 billion, a range that depends on how many eligible seniors enroll.
KFF, a nonpartisan health research organization, projects that the Medicare GLP-1 Bridge will cost between $1.3 billion and $10 billion across its 18 months, a spread that hinges on how many of the roughly 4 million beneficiaries CMS expected might qualify actually enroll [1]. The agency has not released its own spending projection, and it also declined to tell NPR how many people are using the program [1].
The Bridge opened July 1, 2026, and is scheduled to close at the end of 2027 [1][2]. Beneficiaries who qualify pay $50 a month for the drugs, and a prescriber must file a prior authorization request attesting that the medication is for weight reduction [2]. For scale, KFF pointed out that Medicare Part D spent $181 billion on prescription drugs in 2025 [1].
Early volume figures suggest the program is being used. CVS reported filling more than 100,000 Bridge prescriptions by mid-August, and Walgreens said it had filled about the same number [1]. Walmart did not give a count, but said Bridge prescriptions had been processed at more than 5,000 Walmart and Sam's Club pharmacies nationwide and were rising week to week [1]. CMS Administrator Mehmet Oz said in a July 29 video posted to X that 250,000 beneficiaries had signed up; whether those people cleared the prior authorization step needed to actually fill a prescription is not clear [1].
Jeremy Shane, a nonresident scholar at the USC Leonard D. Schaeffer Institute for Public Policy & Government Service, said the two chains' numbers suggest somewhere between 5% and 10% of eligible beneficiaries took part in a short span, assuming other pharmacies filled similar volumes. "I think those are big numbers and they're encouraging about the demand for those medications," he said [1].
Walgreens chief pharmacy officer Rick Gates said roughly half of the Bridge customers his chain has served had not taken a GLP-1 before. He said the company stocked extra Wegovy, Zepbound and Foundayo ahead of the launch and has not run into supply problems. Pharmacists, he added, can help patients stay on treatment through early side effects such as nausea and diarrhea [1].
Why it matters for patients
Federal law bars Medicare from covering drugs prescribed specifically for weight loss, so the Bridge is the main pathway for beneficiaries who have obesity without another covered indication [1][2]. Qualification runs through clinical criteria: a BMI of 35 or higher; a BMI of 30 or higher paired with uncontrolled hypertension, heart failure with preserved ejection fraction, or chronic kidney disease stage 3a or worse; or a BMI of 27 or higher alongside prediabetes, a previous heart attack, a previous stroke, or symptomatic peripheral artery disease [2]. Covered products are Wegovy and Foundayo in all formulations and the KwikPen version of Zepbound [2].
People with obstructive sleep apnea or type 2 diabetes cannot use the Bridge, because Part D is supposed to cover GLP-1s for those diagnoses [1]. A prior authorization request has to be approved before a prescription can be filled [2].
Cost is a persistent obstacle for this drug class. In KFF polling, 56% of GLP-1 users said the medications were difficult to afford, and one in four said they were very difficult to afford [2].
The spending estimate also feeds a debate about how to judge the program. Shane argued that cost is "the wrong way of looking at it," saying the value comes from slowing disease progression in people who have multiple chronic conditions. A paper by his USC colleagues, published a few years ago, concluded that a decade of expanded Medicare access to GLP-1s could reduce health care spending and improve quality of life, with savings showing up in areas such as dialysis and hospitalizations rather than in the drug budget alone [1].
What happens next
The Bridge is authorized through December 31, 2027 [2]. A larger demonstration, the BALANCE Model, has been indefinitely delayed for Medicare Part D, but state Medicaid agencies can run it from May 2026 through December 2031 [2]. Semaglutide, sold as Ozempic, Wegovy and Rybelsus, was selected for Medicare drug price negotiation in 2025, with a negotiated price set to take effect in 2027 [2]. CMS has not said how many Bridge prior authorization requests have been approved [1].
Sources
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