Health Insurance Medicaid Obesity Pharmaceuticals

Medicaid Coverage and Reimbursement of Antiobesity Medications across States

Medicaid policies vary from state-to-state. With the advent of new, GLP-1 medications (and others) to treat obesity and overweight, there are potentially significant health benefits to be gained. However, are State Medicaid Agencies actually covering these medications? This is the question asked by Liu et al. (2024). They use data from public state Medicaid formulary and preferred drug list files to determine if a state covered FDA-approved anti-obesity medications. The number of reimbursed prescriptions for each antiobesity medication was identified from public 2011-2022 Medicaid State Drug Utilization data.

In general, some but not all anti-obesity medications are covered. Moreover, the more effective GLP-1 medications are typically only covered if they are used to treat diabetes (rather than overweight or obesity).

In the first quarter of 2023, 10 of 47 states (21%) with public preferred drug lists covered at least 1 antiobesity medication; 5 (11%) had unrestricted coverage of at least 1 antiobesity medication…Separately, 39 states (83%) had unrestricted coverage of at least 1 of the 2 diabetes versions of GLP-1 RAs.

The full article is here.