High Costs Prevent Most Medicaid Programs From Covering GLP-1s for Weight Loss
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Nov 21, 2024
Medicaid coverage of GLP-1 drugs, which were initially developed for Type 2 diabetes but have made global headlines for their effectiveness in treating obesity, remains limited due to their high costs. Just 13 state Medicaid programs currently cover GLP-1s for weight loss, according to new research from KFF. But while most states don’t cover any obesity medications, KFF found that about half are considering adding coverage in the future with the promise of longer-term savings in mind.
Medicaid prescriptions for GLP-1s surged by more than 400% from 2019 to 2023, while gross spending grew by 500% to nearly $4 billion. This is largely driven by diabetes patients, but the versions of the drug indicated for weight loss made up a rising share in overall prescriptions and spending in 2023. KFF found that every state that does cover GLP-1s under Medicaid for obesity treatment has implemented utilization management practices, such as prior authorization, comorbidity requirements and BMI requirements, to manage the expense.
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