One in five state Medicaid programs covers weight loss medications

Mounting evidence suggests that FDA-approved weight loss medications, such as Wegovy, not only help patients lose weight but also protect against complications from obesity such as cardiovascular disease. In 2021, 40 percent of patients enrolled in Medicaid had obesity. The high cost of these drugs has raised concerns about affordability, both for patients and public insurance programs.

Researchers from Brigham and Women’s Hospital, a founding member of Mass General Brigham, studied state Medicaid coverage policies for anti-obesity medications from 2011 through the first quarter of 2023, finding that 10 out of 47 states covered at least one anti-obesity medication. Their results are published today in JAMA. “At least 1 in 5 states offer coverage for one or more anti-obesity medications, and that trend has increased in recent years,” said corresponding author Benjamin Rome, MD, MPH, of the Division of Pharmacoepidemiology and Pharmacoeconomics. “Newer medications are remarkably effective, but they are quite expensive, which is a major concern for states when deciding whether to cover these drugs. States or the federal government need to negotiate lower prices to help ensure access to effective anti-obesity drugs for vulnerable Medicaid patients while addressing budgetary concerns.”

Paper cited:  Liu YB and Rome BN. “State Coverage and Reimbursement of Antiobesity Medications in Medicaid.” JAMA 10.1001/jama.2024.3073