RALEIGH, N.C. (WNCN) – The use of weight loss medications has skyrocketed across the country and in North Carolina. Currently, around 4% of state employees–more than 23,000 individuals– have coverage for medications like Wegovy and Saxenda. The injectable medications have become popular for helping those with obesity and diabetes.
On Thursday, the North Carolina State Health Plan continued to discuss coverage of these medications during a board of trustees meeting. State Treasurer Dale Folwell said drug manufacturers have created unfair costs and suggested removing coverage for the popular drugs.
Specifically pointing to the company Novo Nordisk, Folwell said, “Over the last several months we’ve been made aware that the costs of this one drug in total could approach over $150 million in one calendar year and that’s a significant hit to the state health plan that we were not anticipating.” He added, “We’re not questioning the effectiveness of these drugs, what we want is we want to pay the same price for these drugs that people in their home country of Denmark pay for this particular drug.”
With rapidly increasing health costs, Folwell said the State Health Plan is currently facing a $4.2 billion budget gap over the next five years.
Since 2015, the Plan has provided coverage for weight loss prescription drugs. Medications including Wegovy were added in 2021 and have increased in costs from $3 million per month three years ago to now around $14 million per month. If trends continue, state leaders project costs to exceed $600 million annually before rebates within the next five years.
Folwell and staff said the financial impact is not manageable and recommended coverage exclusions that would mainly impact those using the drug for weight control. Individuals who are prescribed the medications to manage diabetes would still be able to receive coverage.
During Thursday’s meeting, some state employees and even health experts explained how eliminating coverage could be detrimental for many—especially those who rely on the drug for serious health concerns. One nurse practitioner said the removal of coverage would be a giant step backward.
Due to the long discussion and several points brought up during the meeting, board members decided to hold off on making any permanent decision. A moratorium will be effective for new users beginning Jan. 1, but board members hope to take recommendations brought up during the meeting to make a final decision later next year.
