German obesity medication reimbursement debate

Discussions regarding the reimbursement of GLP-1-based weight-loss medications in Germany have intensified. Sonja Optendrenk, chair of the Gemeinsamer Bundesausschuss (G-BA), suggested that statutory health insurance should consider covering drugs like Wegovy and Mounjaro, which are currently classified as “lifestyle” products paid for out-of-pocket. Optendrenk proposed that the legislature task the G-BA with defining qualifying patient groups and treatment durations, while noting the necessity of accompanying lifestyle measures.

As usage trends rise, with 12% of the German population using these injections and 27% considering them, concerns regarding the financial burden on statutory health insurance (GKV) have emerged. Carola Reimann, head of the AOK Federal Association, warned that covering patients with a BMI of 30 or higher could cost approximately 45 billion euros annually, while coverage for those with a BMI of 35 or higher could reach 14 billion euros. Reimann also cautioned against a “huge media hype” driving cosmetic use without medical necessity and raised concerns about high drug prices relative to the evidence of their additional medical benefit.