Roughly one-third of the Department of Veterans Affairs' projected medical budget shortfall in 2025 is due to the costs of new medications, including weight-loss drugs like Wegovy and Zepbound that are increasingly being prescribed for vets.
Discussing a revision of the department's anticipated funding shortfall in 2025 with reporters Monday, VA Under Secretary for Health Dr. Shereef Elnahal said roughly $2 billion of the $6.6 billion requested from Congress is needed for weight-loss drugs known as glucagon-like peptide 1, or GLP-1, agonists, and new medications for illnesses found in veterans, such as metabolic dysfunction-associated steatohepatitis, or MASH, a fatty liver disease.
"Part of the reason we need the funding is that we know the need for new drugs for obesity ... and novel medications for conditions that are more common in veterans," Elnahal said in a call with reporters Monday. "New drugs on the market that will help veterans cost more."
A 2020 study by researchers at Texas State University's School of Health Administration on obesity in the veteran population found that roughly 70% were overweight or obese. In 2014, the
VA estimated that 78% of enrolled veteran patients were overweight or obese. Excess weight is known to contribute to chronic illnesses such as heart disease, diabetes, osteoarthritis, stroke and certain types of cancer.
The VA maintains its own pharmacy formulary and can decide which medications the department covers but also looks to Medicare's coverage for guidance. Elnahal said the VA needs to prepare to cover the costs of these medications.
On Tuesday, the Biden administration proposed expanding coverage of obesity medications such as Wegovy, Ozempic, Mounjaro and Zepbound for Americans on Medicare and Medicaid.
Currently, the federal health programs cover only the cost of these medications -- roughly $1,000 a month per patient -- if they are prescribed for diabetes or risk of heart disease.
The cost to cover more Medicare patients would be roughly $25 billion and for Medicaid patients $11 billion over 10 years, according to Department of Health and Human Services officials.
The publication of Biden's proposed Medicare coverage of these drugs marks the start of a regulatory process that will not be complete by the time President Donald Trump is inaugurated on Jan. 20 and brings his own health team to Washington.
Robert F. Kennedy Jr., Trump's nominee for secretary of Health and Human Services, said he doesn't support the medications for weight loss and favors healthy eating over drugs.
During an interview with Fox News on Oct. 19, Kennedy said a "fifth" of the cost of a bill in Congress proposed to cover all counseling and weight-loss medications for overweight Americans would provide "good food, three meals a day to every man, woman and child" and would "solve the obesity and diabetes epidemic overnight."
"[The manufacturers] are counting on selling it to Americans because we are so stupid and so addicted to drugs," Kennedy said.
Physician and Rep. Brad Wenstrup, R-Ohio, introduced a bill last year for Medicare to cover weight-loss counseling and anti-obesity drugs.
Dr. Mehmet Oz, Trump's pick to run the Centers for Medicare and Medicaid Services, said the drugs need more study, but he voiced his support for the medications in 2023 on Instagram.
"I respect you no matter what your weight might be, but for those who want to lose a few pounds, Ozempic and other semaglutide medications can be a big help. We need to make it as easy as possible for people to meet their health goals, period," Oz said.
In March, the FDA approved the first drug for metabolic dysfunction-associated steatohepatitis, Rezdiffra, which the company has priced at $47,400 per year before discounts or negotiation.
According to the VA, more than 30% of veterans receiving VA health care have risk factors for MASH and other fatty liver diseases.
The VA on Monday announced that, after examining its expenses in 2024, savings and estimates of future care, it will need an additional $6.6 billion to cover its medical expenses in fiscal 2025 above the roughly $300 billion it requested in its budget.
The figure was down from an estimated $12 billion shortfall officials cited earlier this year.
"We need more funding to continue our clip of providing more care to veterans than ever before," Elnahal said.
Related: VA Checking for Connection Between PFAS Chemicals and Kidney Cancer in Afflicted Veterans
