While no solid usage numbers exist, the program already has at least 200,000 takers, according to Jeremy Shane, a non-resident scholar at the USC Leonard D. Schaeffer Institute for Public Policy & Government Service, in comments to NPR.
“Before Bridge started, Medicare had estimated roughly about 4 million Medicare recipients might qualify for the program,” Shane noted. “And so if you figure this is 200,000 and, you know, there might be as many as twice as many that are out there through other chain drugstores and other prescription pharmacies.”
Medicare hasn’t released any budget numbers, but an independent analysis by KFF, based on the estimated 3.8 million Part D enrollees eligible for the Medicare GLP-1 Bridge as of 2023, indicates between 10% and 25% of enrollees are using the program. For Medicare, the cost range is between $1.3 billion and $3.3 billion (calculated at $245 net monthly, after subtracting the $50 co-pay). If up to 50% to 75% of eligible enrollees entered Bridge, program costs would skyrocket to between $6.7 billion and $10 billion, KFF reported.
Will more Medicare recipients take a bite out of the Bridge weight loss apple?
Experts say 200,000 Bridge prescriptions in under 60 days likely points to significant pent-up demand for Medicare-backed weight-loss drug care. “When a medication suddenly becomes $50, and patients rush to get it, the price was clearly acting as a gatekeeper,” Bidwell Cranage, a board-certified family nurse practitioner and the founder of Bidwell Health, told Moneywise. “The clinical demand didn’t appear overnight, but user affordability has been an impactor.”
Other healthcare analysts say the Bridge program’s growing numbers could create major issues for Medicare if it pulls the rug out from under program users when the clock runs out in 2027.
“For Bridge, the real risk isn’t the affordability cliff in the abstract; it’s what people do about it, “ Phil Rosen, director of support and operations at Florida-based Lighting Step Technologies, a unified behavioral health SaaS company, told Moneywise.
According to Rosen, every time a legitimate weight loss drug access channel has tightened before, with the 2022-24 GLP-1 shortage being the clearest example, people who lose affordable, legal access don’t just stop treatment; they go looking for alternatives.
“That could include compounded drug versions through pharmacies of varying legitimacy, or unregulated sellers online,” he noted. “Build a routine for 200,000-plus people at $50 per month, then remove it in 18 months, and you’ve primed a population to look for a cheaper path the moment it does.”
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Long-term external program benefits could be in play
Healthcare experts say the generally positive weight-loss outcomes tied to Medicare’s Bridge could provide a big payoff, especially for program users and the nation’s healthcare budget.
“Taxpayers shouldn’t judge this program by pounds lost,” Cranage said. “The benefits of this program should be viewed from a holistic lens.”
