Next month's launch of a Medicare program providing weight-loss drugs for $50 a month is expected to unleash pent-up demand for Wegovy, Zepbound and other blockbuster treatments — and create new bottlenecks at doctors' offices.

The big picture: It could become one of the biggest drug rollouts ever — and it could test an already burdened system as seniors seek new GLP-1 prescriptions.

• Clinicians worry that could also give short shrift to patient counseling on how to take the injectables and pills, adjust dosages and deal with side effects.
• Medicare has been prohibited by law from covering weight-loss drugs.

Where it stands: The new program is part of a deal President Trump struck with Eli Lilly and Novo Nordisk to cut prices for their diabetes and anti-obesity drugs in exchange for access to more patients.

• Providers are bracing for an onslaught beginning July 1, with roughly 14 million Medicare beneficiaries overweight or obese, according to KFF.
• "I have a long list of people who are just holding their breath until July 1, who just could not afford the medication before," Christopher Weber, a board member of the Obesity Medicine Association, told Axios.

First, though, they'll have to go through a verification process, or "prior authorization," to determine whether they qualify for the low-cost drugs.

• "We're already in primary care and obesity medicine kind of overwhelmed with prior authorizations ... this is going to overwhelm a lot of clinics," Weber said.

Medicare administrators have told doctors they are streamlining the process and establishing a central clearinghouse for the reviews.

• "In our situation we would have to double or triple our pharmacy team, and to my knowledge, that has not happened in preparation for this," said Annie Moore, an internal medicine doctor at the University of Colorado.

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Federal officials are deploying emergency measures against New World screwworm, with the threat of an outbreak adding to the GOP's vulnerabilities ahead of the midterm elections.

Why it matters: Trump and the Republican Party are already reeling from soaring beef prices and accelerating inflation. And the Ebola and hantavirus outbreaks have put a new focus on preparedness against infectious diseases.

State of play: The Department of Agriculture is gearing up for a $1 billion-plus fight against the screwworm.

• The first case of screwworm in the U.S. was detected in South Texas on June 3 — one day after Agriculture Secretary Brooke Rollins denied a claim that the parasitic fly was found within a mile of the U.S.-Mexico border.

Zoom in: The arrival of the flesh-eating pest comes a year after the USDA's Animal and Plant Health Inspection Service lost more than 2,100 employees — roughly 25% of its workforce — as part of the administration's federal workforce cuts.

• Trump officials are pointing the finger at the Biden administration and attributing the spread of the flies to the northward migration of people and livestock.

Democrats draw a direct line between the administration's workforce cuts and its inability to keep the screwworm out of the U.S.

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A government watchdog report found leading Medicare Advantage plans turned down requests for rehabilitation and long-term care for seniors at higher rates than their peers.

Why it matters: Denials stemming from prior authorization reviews have generated huge controversy in privately run Medicare plans for the way they can cause administrative headaches and delay care.

What they found: The HHS inspector general found that in June 2024, Medicare Advantage plans denied almost two-thirds of requests for enrollees who needed hospital-level care for extended periods of time and more than half of requests for admission to rehabilitation facilities.

• UnitedHealth Group, Humana and CVS Health received the most requests and had among the highest denial rates, which reached as high as 80% for long-term care.
• In some cases, high denial rates were driven by contractors working for Medicare Advantage plans. Many decisions were overturned on appeal.

Context: Rehabilitative and long-term care is often needed for older patients recovering from a stroke, major surgery or serious illnesses.

• The report found the average cost of a stay at a long-term care hospital in 2023 was $49,000. It was $24,000 for a rehabilitation facility.
• Top health plans say prior authorizations are necessary to help control health care spending and have made commitments to streamline the process.

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