Victoza Pen for type 2 diabetes will not be covered by any Part D plans in my are for 2025.

[JalnidhiS559062]

 Both me and my wife are taking Victoza injection for type 2 diabetes treatment. Victoza was covered by Part D plans in my area (zip code 27526) since 2020 when we first enrolled in Medicare. Now when we are shopping for Part D plans for 2025, none of the 19 Prescription Drug plans cover Victoza? This is due to Biden's bill which limits the maximum drug cost to $2,000 in 2025. In order to keep the cost down all the insurance companies will stop covering name brand drugs for diabetes treatment. Premiums will go up more than inflation for Part D as well to cover the $2,000 cap.

AARP should have advocated to make sure that insurance companies cover all the drugs they were covering during 2024 for 2025 and onwards. Want to know anyone else in similar situation as we are and what they are doing about drugs not covered during 2025 Part D plans.

[GailL1]

@JalnidhiS559062 

Victoza now has an FDA approved generic - so yes, because or price the name brand has been replaced by the generic version for the treatment of type 2 diabetes.  Victoza (liraglutide) - the generic version from what I have read is chemically exact to the brand medication.  In fact, a person on Victoza can just ask their pharmacist to change them to the generic version without an OK from the prescribing doctor.

CMS (Center for Medicare and Medicaid Services) oversees all the rules of coverage for Medicare Part D plans, whether free-standing or within a Medicare Advantage plan.  CMS highly supports the use of generic equivalent meds as well as those that are biosimilar especially if approved by the FDA.   So I think you might be out of luck finding the brand med. now on any Part D formulary - 

Are you able to find the generic version on any Part D plan to which you have access?   TEVA liraglutide and there is one other.  

 As an added concern, Victoza is a glucagon-like peptide-1 (GLP-1) agonist (class of med).  This is also the group of meds that have been linked to weight loss to which Medicare does not cover as a reason to be prescribed this type of med although in combination with another reason like type 2 diabetes, cardiovascular disease, if FDA approved, they can be prescribed.  

Victoza was never linked to this off-label use like the newer versions of the glucagon-like peptide-1 (GLP-1) agonists.  But one should never say never especially where it concerns this type of very expensive medication - weight loss.    The main concern right now is if approved for this use and if the demand really starts to hit Med Part D - they just may break the bank, so to speak.  

And now this is the 1st FDA approved generic to otherwise, really expensive medications in this same category.