South Carolina has become the 14th state in the US to cover weight loss medication Wegovy for its Medicaid patients, marking a significant development in the treatment of obesity. The approval comes after a lengthy process, which includes strict prerequisites and high costs.
The state’s Medicaid agency estimates that only 1,300 beneficiaries will meet the stringent requirements for coverage, with beneficiaries requiring proof of increased exercise activity and weight loss milestones before their medication can be approved.
Wegovy belongs to a pricey class of drugs called GLP-1s, which have transformed the treatment landscape for obesity. The monthly price tag for cash-paying customers is now $499, but health insurance plans and Medicaid recipients may pay more due to higher costs.
California Governor Gavin Newsom has proposed eliminating Medicaid coverage of GLP-1s starting in 2028, while North Carolina’s State Health Plan Board voted to end coverage last year. However, Secretary Robert F. Kennedy Jr. expressed optimism about the future availability of these medications for Medicare and Medicaid patients as costs decrease.
Public health experts have welcomed South Carolina’s decision, but acknowledge that it will not address the vast majority of the state’s obese population. Instead, they emphasize a comprehensive approach to reducing obesity rates, including physical activity promotion, nutrition education, and expansion of outdoor walking trails.
Campbell, who recently underwent weight loss surgery and began injecting Wegovy weekly, expresses gratitude for Medicaid coverage and believes that these combined treatments will help her achieve her weight loss goal.
Source: https://kffhealthnews.org/news/article/glp1-drugs-weight-loss-obesity-trump-medicaid-coverage-south-carolina