These 9 states cover Wegovy through Medicaid

Five states offered unrestricted coverage of the weight loss drugs Wegovy and Saxenda, a study published March 14 in JAMA found. 

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The study examined formularies for 47 state Medicaid programs in the first quarter of 2023. 

Ten states covered Saxenda or Wegovy, the two GLP-1 drugs approved for weight loss. Five of those states restricted coverage of the drugs through non-prefered status, prior authorization or step therapy. 

Most states, 39, covered Ozempic, Victoza or Trulicity, GLP-1 drugs approved to treat diabetes. 

Some states and employers have been hesitant to cover GLP-1 drugs, which come with a list price of up to $15,000 annually. 

These states offer unrestricted coverage of Wegovy and Saxenda in Medicaid, as of 2023: 

  1. California
  2. Delaware 
  3. Minnesota
  4. Rhode Island 
  5. Virginia 

These states offer restricted coverage of Wegovy and Saxenda: 

  1. Georgia (Saxenda only) 
  2. Michigan
  3. New Hampshire
  4. Pennsylvania
  5. Wisconsin 

The study was conducted by researchers at Beth Israel Deaconess Medical Center and Brigham and Women’s Hospital in Boston. See the full study here. 

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