Medicaid Coverage and Reimbursement of Antiobesity Medications across States – Healthcare Economist





Medicaid policies vary from state to state. With the advent of new GLP-1 (and other) drugs to treat obesity and overweight, potentially significant health benefits can be gained. However, do state Medicaid agencies actually cover these medications? This is the question you ask Liu et al. (2024). They use data from the state’s public Medicaid formulary and preferred drug list files to determine whether a state covered FDA-approved anti-obesity medications. The number of prescriptions reimbursed for each anti-obesity medication was identified from public 2011-2022 state Medicaid drug utilization data.

In general, some, but not all, anti-obesity medications are covered. Additionally, the most 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 anti-obesity drug; 5 (11%) had unrestricted coverage of at least 1 anti-obesity drug… Separately, 39 states (83%) had unrestricted coverage of at least 1 of the 2 diabetes versions of GLP-1 ARs .

https://jamanetwork.com/journals/jama/fullarticle/2816585

The full article is here.



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