Drugs for weight loss no longer covered by state workers’ health insurance

NORTH CAROLINA — State workers like teachers and cops will no longer get help losing weight on North Carolina’s dime.

Effective Monday, the North Carolina State Health Plan no longer covers popular GLP-1 drugs for weight loss, including Wegovy, Ozempic and Saxenda.

The state treasurer says this is about price, not efficacy. Talks with Novo Nordisk, the manufacturer of Wegovy and Ozempic, continue but for now, state employees on the health plan will no longer have these popular weight loss drugs covered by insurance.

“We are not questioning whether it works or not,” Folwell said. “We are questioning how much we should have to pay for it.”

Folwell says the list price of Wegovy is $1,350 a month when a recent study found it only costs around $22 a month to produce it. He says the exact same product overseas is less than $300.

As of Monday, the state health plan doesn’t cover drugs like Wegovy or Ozempic for weight loss purposes. Folwell says they would have had to raise the cost of insurance for everyone on the plan too much to justify the coverage for the more than 20,000 people who use the drugs for weight loss.

“We are not just watching the pennies and paperclips, but we are trying to do the most good for the most number of people,” Folwell said.

Emily Weaver, a nurse practitioner who specializes in obesity medicine for True You Weight Loss of Cary, says she’s worried about the impact the lack of coverage of these drugs will have on patients who need them.

She’s encouraging people to talk to their providers about other options.

“Once patients stop these GLP-1 medications about two thirds of the weight that they’ve lost, on average, they will regain over the course of a year,” she said. “This is not the only treatment that we have available to us. So I think that’s important for patients to remember as well that there are still options.”

Nova Nordisk released a statement that says in part, “denying patients coverage for FDA-approved therapies further perpetuates the stigma and bias that obesity is a choice rather than an AMA recognized chronic disease.”

The drugs will still be covered for patients who use them for diabetes.

Read the full statement from Novo Nordisk:

“We are surprised and disappointed North Carolina rejected multiple, workable options presented to them since the last Board meeting in January. Instead, State Health Plan officials are abandoning their obligation to employees living with the chronic disease of obesity and denying them coverage for safe and effective treatments. Denying patients insurance coverage for important and effective FDA approved treatments is simply irresponsible.

“Additionally, the Board of Trustees made this decision falsely asserting that the plan would not receive over $50 million in rebates because of previous obesity coverage changes. This is simply incorrect, and this false assertion was used as part of the justification to end coverage for state employees and the record has not been corrected.

“We stand committed to finding meaningful solutions to manage costs, but we steadfastly oppose leaving patients without coverage – especially when that coverage can ultimately save the healthcare system and the economy billions of dollars and address a national epidemic that has been plaguing our country for decades. At Novo Nordisk, we will continue to advocate for people with obesity, so that harmful discriminatory actions are eliminated for all patients seeking care.

“For too long people living with obesity have faced stigma and bias, being blamed for their disease. Denying patients coverage for FDA-approved therapies further perpetuates the stigma and bias that obesity is a choice rather than an AMA recognized chronic disease. We are disappointed that the state of North Carolina is choosing short-term alternatives over longer-term health benefits and cost savings.”

(WATCH BELOW: Counterfeit versions of Ozempic reported nationwide, FDA says)