Vermont doctors are asking the Legislature to approve a bill that would dramatically increase access to a new class of weight-loss drugs such as Ozempic and Wegovy.
Physicians told lawmakers recently that the medications, known as GLP-1s, represent a breakthrough in longstanding efforts to improve the efficacy of weight-loss treatment. But they say patients often can’t access the high-cost drugs because they’re not covered by Medicaid and some private insurers.
“I’m really hopeful that going forward we’re able to use the medications that we know work, that are evidence based, and that have support,” Dr. Ashley Miller, a pediatrician who practices in South Royalton, told members of the Senate Committee on Finance.
The Vermont Medical Society recently approved a resolution calling for the passage of Senate bill 164, which would require private insurers and Medicaid to cover the cost of the medications when prescribed by a doctor.
A 2022 report by the Vermont Department of Health found that 27% of Vermonters live with obesity; the federal Centers for Disease Control and Prevention says adult obesity prevalence has jumped by 37% over the last two decades.
Miller said she’s seen a noticeable increase in the number of young patients with obesity. She said they’re statistically at higher risk of developing conditions such as Type 2 diabetes and heart and liver disease. And she said GLP-1s could substantially improve their health outcomes.
“These kids — 12, 15, 17 — if I can effect change now, I can help teach them better nutrition, I can help get them active, I can prevent mental health issues, and hopefully in the long run decrease their total medical cost,” she told lawmakers.
Clinical and pharmacy teams at The Department of Vermont Health Access convened a working group last year to examine the merits of adding GLP-1s to Vermont’s Medicaid formulary.
“The goal of this group is to conduct a cost-benefit analysis of weight-loss treatment options for the Vermont Medicaid population, to pave the way for personalized and sustainable solutions in obesity management,” Alex McCracken, director of legislative affairs for DVHA, told lawmakers. “We recognize the incredible utility of these medications, and we are excited by the potential benefits for patient care.”
Costs of the change could be significant, however. Preliminary estimates forecast added drug costs could hit $75 million annually if lawmakers approve the legislation.
Health experts say obesity doesn’t always correlate with poor health. But they say expenditures on weight-loss drugs could be offset by preventing chronic conditions, such as Type 2 diabetes and heart disease, that are associated with obesity.
McCracken said that since DVHA hasn’t yet completed its study, it can’t yet offer a position on the legislation.
“While we are excited about the prospects here for patient care, we must also balance resource allocation and ensure we’re acting as responsible stewards of state funds,” he said.
Dr. Kimberley Sampson, an obstetrician and obesity medicine specialist in Bennington, said GLP-1s offer a transformative new approach to weight-loss treatment. She said the medications are most effective when paired with other lifestyle and nutrition interventions. But she said the drugs curate an environment that allow behavioral changes to take hold. The FDA has approved the GLP-1 medication Wegovy for use in treating obesity and for some people who are overweight and have weight-related medical problems. Ozempic is approved for treating Type 2 diabetes; the FDA has not approved it for weight loss.
“If you have got a patient that now can listen to the cues of their body, that they now feel satiated, they feel full, that they don’t have those cravings, … we can work on the emotional behavioral eating component. ... We can address the traumas,” she said.
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