Becker's Healthcare June 13, 2024
The majority of ACA marketplace plans cover GLP-1 drugs approved for diabetes, though fewer than 1% of plan formularies include drugs solely approved to treat obesity, a new analysis from KFF shows.
The weight loss medication coverage landscape is complex. Numerous insurers, health systems, self-funded employers and state health plans have ended or restricted coverage for weight loss drugs, which can cost upward of $10,000 a year. Most recently, Blue Cross Blue Shield of Michigan moved to drop coverage of GLP-1 drugs for weight loss in fully insured, large group commercial plans.
Novo Nordisk, the manufacturer of Ozempic and Wegovy, has denounced lawmakers’ heightened scrutiny on list prices of the medications, calling it “misplaced and unfair.” The drugmaker...