How Issues With Government Healthcare Cost Projections Impact GLP-1s

InnovationHealthcareHow Issues With Government Healthcare Cost Projections Impact GLP-1sByJoshua P. Cohen,Senior Contributor.Forbes contributors publish independent expert analyses and insights. Joshua Cohen is a Boston-based writer who covers health policy.Follow AuthorJun 05, 2026, 03:12pm EDT--:-- / --:--This voice experience is generated by AI. Learn more.This voice experience is generated by AI. Learn more.Healthcare spending projections are often inaccurate. This problem is amplified when (possibly wrong) estimates inform decisions related to coverage of drugs such as weight loss GLP-1s.gettyEconomics has been called the dismal science, a term coined by the Scottish historian Thomas Carlyle in 1849. One of the things he criticized economists for was their inability to predict well.Well, the predictive capacity of economists hasn’t gotten all that much better in the past 175 years. At the same time, forecasts remain central to healthcare policy evaluation, as well as the scoring of legislation in terms of budgetary impact and implementation of regulatory changes.Two federal government entities, the Centers for Medicare and Medicaid Services Office of the Actuary and Congressional Budget Office, make (sometimes) flawed predictions for many of the same reasons. Perhaps first and foremost there’s an understandably heavy reliance on assumptions. All economics modelling depends on presuppositions that may or may not hold.Take, for instance, CMS models focused on prescription drugs that depend heavily on historical baseline averages. This may not properly account for the budgetary implications of certain newly or recently approved blockbuster medications entering the market. To illustrate, CMS missed the massive spike in prescription drug spending caused by the launch of hepatitis C medicines, starting with the therapeutic Sovaldi in 2014. More recently, early projections failed to accurately grasp the massive rise in use of popular GLP-1 medications in Medicare and...