North Carolina will join the list of several states that have started covering obesity drugs, citing the positive effect they can have not just on weight, but with the comorbidities that often accompany it.
Coverage under the program will begin on Aug. 1 for FDA-approved obesity medications for patients 12 years and older. The state joins California, Connecticut, Delaware, Wisconsin and others that have made similar decisions.
In its announcement, North Carolina said it added the drugs to the health insurance program for lower-income individuals because the treatments “are now playing a role in addressing the obesity epidemic, as they may provide additional weight loss benefits compared to lifestyle modifications alone.”
“This new coverage helps to mitigate gaps in care that are unaddressed by currently covered services and reach eligible beneficiaries who are most at risk of obesity-related health complications,” the state added in its announcement, specifically noting the benefits of GLP-1s, including their weight loss and blood sugar effects, and positive impact on cardiovascular events.
The decision ironically comes after the board governing North Carolina’s health plan for state employees voted earlier this year to stop coverage of obesity medications. The plan spent more than $1 million on weight loss drugs in 2023.
Decisions about whether to cover the drugs continue to play out in health plans and government programs across the country.
In Connecticut, for example, the state employee health plan has continued to offer the new drugs, but through a contract with a health tech company that monitors patients and helps manage their care. When the program was announced, Connecticut Comptroller Sean Scanlon said the state employee health plan “was seeing an unsustainable 50% year-over-year increase in spending on GLP-1 weight loss drugs.”
The Centers for Medicare & Medicaid Services also released its own guidance for weight loss drugs in March: They can be covered under Medicare Part D as long as they have FDA approval for an additional medically accepted indication, like Novo Nordisk’s Wegovy, which was approved earlier this year to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease.