Spending on GLP-1s in Medicaid has followed broader industry trends, growing significantly over the past several years, according to a new study from KFF.
The analysis found that the number of prescriptions for these drugs grew by more than 400% between 2019 and 2023, while spending grew by 500%. Per prescription, spending was more than $900 before rebates, according to the report; the KFF researchers note that states often receive substantial rebates on drugs.
There were about 755,300 prescriptions for GLP-1 drugs in 2019, according to the report, which rose to 3.8 million in 2023. The largest share, about 2.1 million, of those prescriptions were for Novo Nordisk's Ozempic.
By comparison, about 158,200 prescriptions for Ozempic were dispensed in 2019, according to the study.
Thirteen states currently cover GLP-1 drugs for obesity, while four more have coverage available but not for treating obesity. Medicaid plans in the remaining 34 states and the District of Columbia do not cover these drugs, KFF said.
The researchers found that several states plan to add coverage in fiscal year 2025, while about half are considering whether to add coverage for GLP-1s.
When asked, two-thirds said cost was a key factor in determining whether to add coverage. Other concerns included adherence, potential side effects and clinical criteria. On the positive side, 4 in 10 states said they saw potential long-term health benefits and cost reduction should they provide access to GLP-1s.
"States are likely considering various cost containment strategies for these drugs and may even be re-evaluating their broader approach to obesity treatment, including the use of obesity medications along with other treatments such as nutritional counseling or behavioral therapy," the researchers wrote in the report.
"Obesity is caused by a multitude of complex factors, and uptake of GLP-1s could improve health but would not address all of the underlying contributors to obesity," they added.
The KFF study notes that limited coverage isn't exclusive to Medicaid, as many large employer firms do not cover GLP-1s. Medicare is barred from covering drugs for weight loss, and coverage is also limited in plans available on the Affordable Care Act's exchanges.