RALEIGH, North Carolina — About 24,000 people who are covered by the State Health Plan were already taking prescription drugs to help them lose weight when they found out that their insurance would no longer pay for them. Drs are worried about how that will affect their patients now that it’s less than a week away.
According to Dr. Andrea Coviello, medical director of the UNC Weight Management Program, treating obesity is a long-term health goal for most people. It can help them reverse chronic diseases they already have or keep them from getting them in the first place. Heart disease is still the leading cause of death for both men and women in the United States.
Health problems like heart disease, diabetes, and cancer that are caused by being overweight can cost insurance companies hundreds of thousands of dollars per patient. The NC treasurer’s office said the state can’t afford some drugs like Wegovy after spending $138 million on weight loss drugs last year.
The state controller says that It costs $1,349.02 a month for each member to buy Wegovy and Saxenda. After discounts, the weight loss drugs cost more than $800 per member per month. In the Netherlands, Novo Nordisk sells the same product for $296 per month.
As of April 1, Dr. Covielo said she is paying close mind to the due date.
“I have patients on the state health plan whose conditions will get worse if they lose coverage and gain weight. That’s why I’m very worried that those people with very serious conditions that get better when they lose weight keep their coverage.” “The data we have shows that these medicines are a good value for money when it comes to treating or preventing chronic diseases,” Dr. Covielo said.
She also said that the U.S. health care system has two main problems when it comes to the costs of fat. She said one is the growing number of people who are overweight or obese.
“Right now, about 42% of adults in the U.S. are obese, which means that a lot of people can take this kind of medicine according to general guidelines from professional societies.” Because so many people are eligible and these medicines are expensive, there is an economic problem that needs to be solved: how much can the healthcare system afford to pay for these medicines to get the health benefits? I think that’s the problem the U.S. healthcare system is having right now. “This is true not only in North Carolina but all over the country for these kinds of medicines,” Dr. Covielo said.
The state made it clear that they are still in talks with Novo Nordisk and CVS Caremark and are hoping that a deal can be reached.
When asked about the talks, Dr. Covielo said, “I know they’re getting close, and I’m hoping that they can come up with a way to slowly get back to coverage for most of their more than 700,000 clients.” I’m somewhat hopeful that they start with the patients who need it the most and who will benefit the most from continuing this therapy over the next six to twelve months. On the other hand, I’m very hopeful that they follow through on their earlier recognition that prevention is key.