The federal government’s recent announcement to lower prices for obesity drugs and to expand their access to Medicare enrollees could help millions of people struggling with obesity, primary care providers and obesity specialists said.

But it raises questions not only for patients but also for their primary care providers as they field questions about eligibility and coverage status from patients who are yearning for help.

The announcement, which came during the annual Obesity Week meeting in Atlanta, caused an immediate stir among physicians gathered there. Many have been lobbying for coverage of the medications since Wegovy, the first of the drugs approved to treat obesity, came on the market in 2021. They have seen the marked improvements in their patients’ health, some of which have been lifesaving.

“You could see everyone in the big lectures pulling out their phones to read the news,” said Catherine Varney, DO, a primary care physician who is board-certified in both family medicine and obesity medicine at UVA Health in Charlottesville, Virginia. “It’s a huge win for access.”

Others were similarly excited.

“They are the closest thing to magic that I have,” said Amy Sheer, MD, MPH, an associate professor at the University of Florida School of Medicine, Gainesville, Florida, and a member of the American Board of Obesity Medicine.

The wonder drugs are made by pharmaceutical giants Eli Lilly and Novo Nordisk. Both companies agreed to lower prices partly in exchange for relief from tariffs and partly in exchange for expedited approval for oral medications that are pending consideration.

Lilly’s big new potential blockbuster is orforglipron, a newer generation drug that has been shown in clinical trials to result in a 20% weight loss. Novo awaits approval for an oral version of Wegovy, an injectable that already is on the market to treat obesity.

The companies agreed to cap the cost of those new pills, if approved, at $149 a month. The market for daily pills rather than a weekly injection is expected to be huge, financial analysts have said.

And Lilly already has seen earnings and valuation soar, thanks to its obesity drug Zepbound and diabetes medication Mounjaro. In mid-November, the company announced its valuation at more than $1 trillion, making it the first pharmaceutical company to hit that mark.

With the expansion of the coverage to Medicare enrollees with obesity and a history of stroke or heart attack 1 in 10 Medicare enrollees — or about 7 million people — could gain access to the medications. And they would pay no more than $50 a month.

The new prices are expected to be available next year.

That one change would mark a major shift. The Biden administration came close in 2024 to a plan that would have allowed for Medicare to reinterpret the statute and to cover obesity as a chronic illness. Projected costs for a decade of coverage under Medicare were $25 billion.

When President Donald Trump came into office, that plan was halted.

Many primary care providers said they understand that the financial costs were high. But they see another factor at play, as well.

“A lot of the rules are in place because of financial considerations but also they are there because of bias and stigma,” said Angela Fitch, MD, a former president of the Obesity Medicine Association. “The world still thinks that obesity is the patients’ fault. We have to get around that notion.”

But hurdles remain for patients, and some primary care providers are concerned that many of their patients will still be unable to afford the medications. Primary care providers are not only having to sort through some confusing details of the plan for their own understanding but also trying to give accurate and helpful information to their patients. And some primary care providers are concerned about whether new guidelines might mean an even more onerous prior authorization process.

“When you look at it, and the cost savings, and the potential to help millions of people, it’s uplifting,” said Rebecca Andrews, MD, a primary care physician and chair of the board of regents for the American College of Physicians and also a professor of medicine at the University of Connecticut, Farmington, Connecticut. “But is it stable? I’m still not sure how it’s going to play out.”

They do want it to play out — or at least to result in improved health for their patients.

The injectable drugs have been shown to reduce overweight in about 80% of those who take them, with some patients reporting as much as a 35% weight loss.

But costs — as high as $1350 each month — and strict coverage criteria have limited their use by millions more patients who could possibly benefit from them.

Some primary care physicians are concerned about prior authorizations under the new plan.

“This really doesn’t say anything about prior authorization,” Andrews said. “Will you have to prove that other drugs have failed? It’s heart-breaking to have to say, ‘yes, it’s FDA-approved, but your insurance company may not cover it.”