State Health Plan nixes weight loss drug coverage

By a 4-3 vote on Thursday, the State Health Plan Board of Trustees voted to end coverage of GLP-1 drugs for the treatment of weight loss on April 1, including for those patients currently grandfathered in. The Plan will continue to cover the drugs in the treatment of diabetes.

The vote came after a long debate over the drugs’ cost and impact on the State Health Plan. Around 25,000 members currently take the drugs – five times as many as this time last year. Continued coverage of the drugs would result in a $48.50 increase in premiums for all plan members.

In our first podcast episode, SEANC Executive Director Ardis Watkins and Communications Director Jon Owens dive into the topic. Why are these drugs four times higher in the US than in Europe? What's a PBM? Who is really to blame here?