One in Five State Medicaid Programs Cover Antiobesity Medications

THURSDAY, March 21, 2024 (HealthDay News) — As of early 2023, one in five state Medicaid programs covered antiobesity medications, according to a research letter published online March 14 in the Journal of the American Medical Association.

Benjamin Y. Liu, M.D., from Beth Israel Deaconess Medical Center, and Benjamin N. Rome, M.D., from Brigham and Women’s Hospital, both in Boston, examined state Medicaid coverage policies for antiobesity medications and trends in Medicaid reimbursement. The analysis included data from the public Medicaid State Drug Utilization Data (2011 to 2022).

The researchers found that in the first quarter of 2023, 10 of 47 states (21 percent) with public preferred drug lists covered at least one antiobesity medication. Five states (11 percent) had unrestricted coverage of at least one antiobesity medication, while 39 states (83 percent) had unrestricted coverage of at least one of the two diabetes versions of glucagon-like peptide 1 receptor agonists (GLP-1 RAs). During the study period, the number of antiobesity medication prescriptions reimbursed by state Medicaid programs increased more than 1,300 percent due to greater reimbursement of GLP-1 RAs. In 2022, 87 percent of reimbursements for antiobesity medications were for liraglutide (Saxenda) or semaglutide (Wegovy). During the study period, the number of states with documented reimbursements for antiobesity medications increased from 13 to 22. 

“In 2021, 40 percent of Medicaid enrollees had obesity,” the authors write. “This prevalence, combined with high prices for GLP-1 RAs, raises budgetary concerns; ensuring access to these drugs for the vulnerable Medicaid population requires states or the federal government to negotiate lower prices.”

Abstract/Full Text