Access to Weight Loss Drug Wegovy Still Limited Despite Medicaid Coverage in South Carolina
CHARLESTON, S.C. — Page Campbell, a 40-year-old single mother of two, has struggled with her weight for years. When her doctor suggested trying Wegovy, an injectable prescription drug, as a weight loss solution before bariatric surgery, she was eager to give it a try. Campbell, who works as a shipping manager, saw this as an opportunity to finally achieve her weight loss goals.
Wegovy belongs to a class of drugs called GLP-1s that have revolutionized obesity treatment, offering hope to patients who have not found success with other weight loss methods. However, access to these medications remains limited due to their high cost, with many insurers deeming them too expensive to cover.
While South Carolina Medicaid recently decided to cover GLP-1s for weight loss, only a few states offer this benefit to Medicaid beneficiaries. The approval process for these drugs is rigorous, requiring documentation of failed weight loss attempts and adherence to strict criteria, such as increased exercise activity.
Despite the excitement among healthcare providers in South Carolina about Medicaid’s decision to cover GLP-1s, the number of beneficiaries expected to access this benefit is relatively low due to the high cost of the medications. Novo Nordisk, the manufacturer of Wegovy, recently reduced the monthly price of the drug, but it still remains expensive for many patients.
California and North Carolina have made decisions to limit or end coverage of GLP-1s for weight loss due to budget concerns. While South Carolina Medicaid estimates a lower cost for covering these drugs, the expense is still a significant consideration for the state.
Public health experts have praised South Carolina Medicaid’s coverage of GLP-1s, but acknowledge that more work is needed to address obesity rates in the state. A comprehensive approach to obesity management should include a combination of interventions, including lifestyle changes, medications, and surgical options.
Despite the challenges, Campbell remains committed to her weight loss journey, combining Wegovy injections with dietary changes and exercise. She also underwent weight loss surgery to further support her goals. Medicaid’s coverage of Wegovy has been a valuable resource for Campbell in her quest for better health.
