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CMS Unveils Voluntary BALANCE Program to Lower GLP-1 Costs for Medicare and Medicaid

The program pairs discounted drug access with no-cost lifestyle support through a phased rollout beginning in 2026.

Overview

  • CMS will negotiate reduced prices with GLP-1 manufacturers for state Medicaid programs and Medicare Part D plans under the BALANCE model.
  • State Medicaid agencies can join in May 2026, a temporary bridge will allow Medicare access by July 2026, and Part D participation begins January 2027, with the test running through December 2031.
  • An administration agreement would set eligible Medicare enrollees’ monthly payment at $50 for certain GLP-1s, with Medicare paying a larger negotiated amount.
  • To qualify, products must include approved GIP/GLP-1/glucagon receptor agonist components and demonstrate at least a 10% average reduction in body weight.
  • Participation is voluntary for manufacturers, states, and Part D plans, with notices of intent due by January 8, 2026, and stakeholder groups urging clarity on costs and safety given concerns about side effects and adherence.