Report: KY Medicaid spends the most on GLP-1s for obesity per capita of any state

The growing popularity of GLP-1 receptor agonists—including Ozempic and Wegovy from Novo Nordisk, and Mounjaro and Zepbound from Eli Lilly—has added fuel to an already fiery debate over the government’s role in subsidizing access to these drugs. Originally developed for Type 2 diabetes, these medications have proven highly effective for treating obesity—a chronic condition affecting more than 40% of U.S. adults. However, with costs often exceeding $1,000 per month for patients who are under- or uninsured, these treatments remain out of reach for many Americans.

Medicare currently limits its coverage of GLP-1s to individuals with Type 2 diabetes or certain heart conditions, excluding prescriptions aimed solely at obesity. Medicaid coverage of GLP-1s for obesity, however, varies by state. While all state Medicaid programs include GLP-1s prescribed for Type 2 diabetes, only 36 states cover at least one of the FDA-approved GLP-1s for obesity (Wegovy, Zepbound, or Saxenda).

Amid the Biden administration’s recent proposal to expand obesity drug coverage under Medicare and Medicaid, experts at Real Chemistry examined which state Medicaid programs currently cover GLP-1s approved to treat obesity and how much they are spending. This study uses Real Chemistry’s IRIS market intelligence platform, which includes over ten years of medical, hospital, and pharmacy claims data from more than 300 million U.S. patients. It examines how state Medicaid coverage for GLP-1 medications varies and the financial impact of these coverage differences.