Wegovy fills rose after FDA and Medicare policy changes

A retrospective analysis in The American Journal of Managed Care found a marked rise in Wegovy prescription fills after the FDA added a cardiovascular-risk indication and Medicare Part D coverage became possible for that use. The study shows an association with the policy change, not proof that policy alone caused every additional fill.

What changed in March 2024

On March 8, 2024, the FDA approved Wegovy to reduce cardiovascular death, heart attack, and stroke in adults with established cardiovascular disease and either obesity or overweight. Because that indication is not solely weight loss, it created a route for Medicare Part D coverage.

How the study measured the response

Researchers analyzed monthly IQVIA National Prescription Audit PayerTrak data from September 2023 through September 2024. The data covered Wegovy, Ozempic, and Rybelsus fills by payer, and a segmented regression estimated fills beyond the pre-policy trend. March 2024 was excluded because the changes occurred midmonth.

• Total semaglutide fills rose from 2,381,016 in September 2023 to 3,341,613 in September 2024.
• Wegovy fills increased 136.4%, from 367,371 in February 2024 to 868,301 in September 2024.
• Medicare Part D Wegovy fills rose 598.1%, from 4,689 to 32,732 over the same comparison.
• The model associated the policy changes with 592,624 additional Wegovy fills by September 2024, with a 95% confidence interval of 464,446 to 720,803.

More fills did not mean broad access

The authors estimated that the 32,732 Part D fills recorded in September 2024 represented less than 1% of roughly 3.6 million potentially eligible beneficiaries. Formulary exclusions, cost sharing, and limited awareness may still have constrained uptake.

Important limitations

• The dataset did not include individual prescribing indications or patient-level outcomes.
• The researchers could not measure co-payments or determine which Part D formularies covered Wegovy.
• Prescription fills measure dispensing, not adherence or clinical benefit.
• The analysis covered six months after the policy change, so longer-term access patterns may differ.

The practical takeaway is that a new clinical indication can open a reimbursement pathway and materially change utilization, while substantial access barriers remain after the policy headline.