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Health Line
a day ago
- Business
- Health Line
Does Medicare Cover Trulicity?
Medicare Part D plans and some Part C plans may cover Trulicity (dulaglutide) for diabetes, but the exact coverage depends on the plan. Such plans will only cover this drug for weight loss in certain cases if you're living with obesity. Trulicity (dulaglutide) is a drug belonging to the glucagon-like peptide-1 receptor agonist (GLP-1) class of medications. Diabetes affects 38.4 million people in the United States, or 11.6% of the population. The Food and Drug Administration (FDA) has approved this drug to help manage type 2 diabetes and reduce the chance of developing heart disease. For this reason, although GLP-1s may be prescribed off-label for weight loss, Medicare Part D plans may cover this drug for diabetes management but not for weight loss, except under specific circumstances. Is Trulicity covered by Medicare Part B? Medicare is generally divided into the following parts: Original Medicare (parts A and B) Medicare Part D Medicare Part C (Medicare Advantage) Medigap Part B Part B mainly covers medications that you cannot administer yourself, such as IV infusions, for example. While Trulicity is an injection drug, it is one that you can inject yourself. For this reason, Medicare Part D would be responsible for covering a drug like Trulicity. Part D Since private insurers manage Part D plans, the exact drugs that each plan covers vary. What drugs a specific plan covers depends on its formulary, which is a list of the covered drugs. Part D plans are generally required to cover at least two drugs from the most commonly prescribed categories. If the plan does not cover Trulicity (dulaglutide), it is likely to cover some brand-name or generic alternative. Medicare's plan finder tool allows you to enter medications you take to see which Part D plans in your area include these medications in their formulary. The tool also lets you compare prices at different pharmacies in your area. Part C Medicare Part C, also called Medicare Advantage, is another option for healthcare coverage under Medicare. These optional, private plans offer the same benefits as Original Medicare. Some Part C plans may also offer other benefits, such as prescription drug coverage. Coverage for specific medications under a Medicare Advantage plan depends on the options and plans that the company you choose offers. When selecting a Medicare Advantage plan, you can specify medications you take to compare coverage and pricing. Why doesn't Medicare cover Trulicity for weight loss? Medicare drug plans typically cover medications when they are considered medically necessary. Therefore, Part D plans or Part C plans with drug coverage won't cover GLP-1 agonists like Trulicity for weight loss. Typically, coverage focuses on FDA-approved uses such as helping manage type 2 diabetes or lowering cardiovascular risks for overweight adults or those living with obesity. Obesity is defined as having a body mass index (BMI) of 30 or greater. This means you could have a BMI between 25 and 30, but would not qualify for a drug like Trulicity through Medicare unless you need it for diabetes. Under the Biden administration, the Centers for Medicare & Medicaid Services (CMS) looked into expanding coverage of GLP-1 drugs for weight loss by 2026. However, the Trump administration has since decided against this expansion. How much does Trulicity cost on Medicare? Trulicity's list price is $987.19 per month, but insurance or Medicare coverage may lower this cost. When a Medicare drug plan covers a drug, how much you'll pay out of pocket depends on the tier your plan classifies the drug within its formulary. Generally, higher-tier drugs cost more. Copays for this medication will vary based on the plan you choose, but the manufacturer suggests a range of $0 to $100 per month after you've met your Medicare Part D deductible. Generic drugs are generally classified in a lower tier, but no generic Trulicity is currently available. How can I lower the cost of Trulicity? Trulicity's manufacturer offers a savings card through which you can get a one-month supply of Trulicity for as little as $25. However, you won't be able to use your Medicare plan if you want this discount. Alternatively, you can check whether you qualify for Extra Help, which can lower your prescription costs to $4 to $9. Other resources for lowering drug costs include: Other tips that may help lower your prescription drug costs include: Ask your doctor about less expensive generic options. Consider switching from a 30-day supply to a 90-day supply for your medications, as buying a larger supply upfront can provide cost savings. Consider a mail-order supplier to save on costs. What is a cheaper alternative to Trulicity? The following chart shows GLP-1 agonists currently available in the United States and their brand-name retail prices before insurance. Available generic versions usually cost less. Brand name (generic name) List price as of 2025 Wegovy (semaglutide) $1,349.02 Ozempic (semaglutide) $997.58 Rybelsus (semaglutide $997.58 Mounjaro (tirzepatide) $1,079.77 Zepbound (tirzepatide) $1,086.37 Saxenda (liraglutide) $1,349.02 Victoza (liraglutide) $543.51 or $815.27 (depending on dose) Trulicity (dulaglutide) $987.19 In addition, other diabetes medications can be covered by Medicare. CMS included several of these drugs in the list of 10 drugs it used to renegotiate prices as part of the Inflation Reduction Act of 2022. Takeaway Trulicity is a long-lasting brand-name medication that can be quite effective at lowering high blood sugar levels due to type 2 diabetes. It is not a substitute for insulin or diet and lifestyle strategies for managing diabetes. There is no generic version of this medication. It is typically a tier 3 medication in most drug plan formulary lists. Many Medicare Part D plans include Trulicity on formularies, but you'll likely still pay a share of the costs. The cost you'll pay will depend on your specific plan. A variety of private and public programs offer extra help in covering your medication costs. You can also talk with your doctor about an affordable way to manage diabetes. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
Medscape
23-05-2025
- Health
- Medscape
GLP-1s Lower Pancreatitis Complications, Mortality in T2D
Patients with type 2 diabetes (T2D) who received glucagon-like peptide 1 (GLP-1) receptor agonists had a significantly lower risk of developing local or systemic complications — even if they developed acute pancreatitis — and showed more than a 50% reduction in risk for all-cause mortality than those who did not receive these medications. METHODOLOGY: Patients with T2D may experience heightened local and systemic complications from acute pancreatitis, often requiring prolonged and intensive care; however, data on outcomes among those treated with GLP-1s remain limited, highlighting a significant knowledge gap. Researchers conducted a retrospective cohort study using population-based data to evaluate the influence of GLP-1s on acute pancreatitis risk and associated outcomes in patients with T2D identified between January 2015 and October 2023. The analysis included 20,459 patients with T2D who received GLP-1s including semaglutide, liraglutide, dulaglutide, or tirzepatide (mean age, 58.1 years; 49.85% women); the patients were propensity score–matched with those not receiving these medications. The primary outcome was the development of acute pancreatitis and the subsequent clinical trajectory of affected patients, including the need for parenteral nutrition, the occurrence of systemic complications, and the incidence of local pancreatic complications. The secondary outcome was all-cause mortality. TAKEAWAY: Patients who received GLP-1s tended to have a lower risk for acute pancreatitis than those who did not, although this finding was not statistically significant. However, among patients with acute pancreatitis, those who received GLP-1s had a significantly lower risk of developing complicated pancreatitis (hazard ratio [HR], 0.32; P = .05) and a reduced need for parenteral nutrition (HR, 0.28; P = .01) than those who did not receive these GLP-1s. = .05) and a reduced need for parenteral nutrition (HR, 0.28; = .01) than those who did not receive these GLP-1s. The risks for systemic complications, including sepsis, acute kidney injury, shock, and the need for mechanical ventilation, were significantly lower in patients who received GLP-1s than those who did not ( P < .001 for all). < .001 for all). The risk for all-cause mortality was 55% lower in those who received GLP-1s than in those who did not (HR, 0.45; P < .001). IN PRACTICE: '[The study] results provide a compelling rationale for reconsidering GLP-1s as not only antidiabetic agents but also as key components in the management of diabetes-related complications, including AP [acute pancreatitis],' the study authors wrote. SOURCE: This study was led by Luis M. Nieto, MD, Division of Digestive Diseases, Emory School of Medicine in Atlanta. It was published online in The American Journal of Gastroenterology . LIMITATIONS: This study did not discuss any limitations. DISCLOSURES: This study received no specific funding. The authors reported having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. Credit Lead image: Tashatuvango/Dreamstime Medscape Medical News © 2025 WebMD, LLC Cite this: Edited by Archita Rai. GLP-1s Lower Pancreatitis Complications, Mortality in T2D - Medscape - May 23, 2025.
