Medicare to Cover Eli Lilly’s Zepbound for Sleep Apnea Treatment

The FDA-approved drug for obstructive sleep apnea marks a significant expansion of access to costly weight-loss medications under Medicare Part D plans.

Eli Lilly's Zepbound, originally developed as a weight-loss drug, is now covered by Medicare for treating obstructive sleep apnea, following FDA approval in December 2024.
The drug demonstrated significant efficacy in reducing sleep apnea symptoms during clinical trials, cutting breathing interruptions by up to 62.8%.
Medicare Part D plans can now include Zepbound in their formularies, though prior authorization may be required to ensure it is prescribed for the approved condition.
The Biden administration had proposed expanding Medicare and Medicaid coverage for anti-obesity medications in November 2024, but implementation under the incoming Trump administration remains uncertain.
Zepbound's high cost, exceeding $1,000 per month without insurance, has limited accessibility, though expanded coverage could reduce out-of-pocket expenses for eligible patients.