CVS恢复覆盖礼来减肥药Zepbound,数百万患者重获保险支持
美国最大药品福利管理公司之一CVS Health宣布,将重新将礼来公司(Eli Lilly)的减肥药物Zepbound纳入其保险覆盖范围。这一决定标志着美国肥胖症治疗保险政策的重大转折。
Zepbound(替尔泊肽/tirzepatide)是礼来公司开发的GLP-1/GIP双重受体激动剂,在临床试验中展现出显著的减重效果。患者平均可在一年内减重超过15%,部分参与者减重比例甚至超过20%。该药物最初于2023年获得FDA批准用于治疗肥胖症。
此前,包括CVS在内的多家保险提供商以成本考量为由,收紧了对GLP-1类减肥药物的覆盖范围。据估计,美国有超过40%的成年人符合肥胖症诊断标准,但仅有不到5%的患者能够持续获得药物治疗。
CVS方面表示,此次恢复覆盖是基于最新临床证据和成本效益分析的决策。随着越来越多的研究表明,GLP-1类药物不仅能帮助减重,还能降低心血管疾病、糖尿病并发症等健康风险,保险提供商正在重新评估其长期价值。
礼来公司对此表示欢迎,称这将使更多符合条件的患者获得必要的治疗。分析师预计,随着更多保险提供商跟进,GLP-1类药物市场将在未来数年保持高速增长。目前全球减肥药市场规模已超过1000亿美元,预计2030年将突破2000亿美元。
然而,药物的可及性问题仍未完全解决。即使有保险覆盖,患者的自付费用仍然可能较高,且部分保险计划仍设置了严格的处方门槛,如要求患者先尝试其他减重方法。
CVS Restores Coverage for Eli Lilly’s Weight-Loss Drug Zepbound
CVS Health announced it will once again cover Eli Lilly’s weight-loss medication Zepbound (tirzepatide), marking a significant shift in obesity treatment insurance policy in the United States.
Zepbound, a GLP-1/GIP dual receptor agonist, has demonstrated remarkable weight-loss results in clinical trials, with patients averaging over 15% body weight reduction within a year. Previously, several pharmacy benefit managers had tightened coverage citing cost concerns.
CVS cited updated clinical evidence and cost-benefit analysis for the decision, noting growing research that GLP-1 drugs not only aid weight loss but also reduce cardiovascular disease and diabetes complications. The global weight-loss drug market currently exceeds $100 billion and is projected to surpass $200 billion by 2030.
Despite the expanded coverage, affordability remains a challenge — out-of-pocket costs can still be significant, and some plans maintain strict prescription requirements.