Nebraska lawmakers mull Medicaid coverage of weight loss drugs

Nebraska lawmakers are considering requiring the state's Medicaid program to cover GLP-1 drugs, the Omaha World-Herald reported Feb. 15. 

State Sen. Merv Riepe introduced a bill in the Nebraska Legislature that would require the state to cover obesity treatments, including expensive GLP-1 drugs like Ozempic and Wegovy. 

The state's Department of Health and Human Services estimated coverage of GLP-1 drugs would cost Nebraska $42.4 million a year if 60% of Medicaid patients with BMIs of 30 or higher and 15% of those with BMIs between 25 and 29 took the drugs. 

Brianna Johnson-Rabbett, MD, who testified on behalf of the Nebraska Medical Association, estimated a much smaller percentage — in states where the drugs are covered by Medicaid, just 1.4% of enrollees who meet the criteria to be prescribed GLP-1 drugs for weight loss actually take them. 

According to a November survey of state Medicaid directors from KFF, 16 states cover at least one form of weight loss drugs through Medicaid. An additional five states are considering adding coverage. 

Some GLP-1 drugs, including Ozempic, Trulicity, Victoza and Mounjaro, are approved to treat Type 2 diabetes, though these drugs are prescribed off-label for weight loss. Wegovy and Saxenda, manufactured by Novo Nordisk, and Eli Lily's Zepbound are approved for weight loss. 

The drugs are expensive, costing patients upward of $10,000 a year without insurance. Federal law bars Medicare from paying for weight loss drugs. 

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