JAMA yesterday published a study which found “savings that would offset the cost of treating an additional 550,000 to 3.6 million Medicare beneficiaries” from the new BALANCE model at CMS. So Bloomberg wrote a story with a headline saying the study’s finding is that “Trump’s obesity drug plan for Medicare would cost insurers billions.” This is a uniquely jolting instance of a headline in conflict with a study in economics.
The Study
The study itself came in the form of a research letter by Stacie Dusetzina and colleagues. They aimed to provide a range of estimates for Medicare spending on semaglutide that resulted from the BALANCE model for treating obesity in Medicare and offsetting savings from lower prices negotiated for semaglutide.
The phrase to bear in mind is “a range of estimates.” Because this was a modeling exercise, it does not produce a single answer. Rather, it describes a range of possible outcomes. The closest this study comes to suggesting high costs for this program is their conclusion that:
“Incentives and additional price negotiations will likely be needed to expand Medicare coverage for weight loss medications.”
Alongside this study, Hamlet Gasoyan and Michael Rothberg published a commentary that highlights the value of the BALANCE model from CMS. They concluded:
“The BALANCE model represents an encouraging step forward because it signals policymakers’ understanding that timely and comprehensive management of obesity can lower comorbidity risks and prevent disease progression.”
The Story
The headline and story from Bloomberg presented a very different story:
“President Donald Trump’s plan to cover weight-loss medications for some people in the Medicare program for the elderly would cost the health insurers billions in its first year, a new analysis found.”
While it is true that the study points to “potential budget implications,” there is no point estimate. A price tag of billions of dollars in cost is nowhere to be found in the study. Bloomberg had a story to tell and the JAMA paper serves only as a prop.
Perspective
The conflict between headline and study is a useful reminder of a fundamental conflict in the economics of obesity. Since forever, we have left obesity untreated. So it progresses and produces a cornucopia of other chronic diseases. But health plans all over the world – and especially in the U.S. – would rather stall on paying for obesity treatment today and let bills pile up down the road for heart, liver, kidney, endocrine, musculoskeletal, and oncologic diseases. They’re happy to let that be somebody else’s problem.
But that somebody else is us.
Click here for the Dusetzina study and here for the commentary by Gasoyan and Rothberg. For the Bloomberg report, click here.
Painting, artwork by Patrick Henry Bruce / WikiArt
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April 03, 2026 at 12:54 pm, Richard Atkinson said:
It appears that the Bloomberg story is another example of Trump Derangement Syndrome. Donald Trump could cure obesity and it would be criticized by the media. Multiple studies have shown that semaglutide or tirzepatide reduce blood pressure, heart disease including up to a 42% decrease in atrial fibrillation, kidney malfunction, potentially reduce neuropathy and perhaps progression of Alzheimer’s disease, etc, not to mention the decrease in obesity. The decrease in drug costs for these diseases and the prolongation of life that has been shown in the literature should convince any logical person that GLP-1 agonists should be covered by the government and by insurance. Unfortunately, the media is not logical.