Pharmalittle: State Medicaid programs seek discounts for Wegovy; congressional PBM bills work around the fringes

By Ed Silverman July 26, 2023

Reprints

Alex Hogan/STAT

Top of the morning to you. And a fine one it is. Lots of sunshine and clear blue skies are once again enveloping the Pharmalot campus, where the short person is sleeping in and the official mascots are racing about the sandlot. As for us, we are as busy as ever hunting and gathering items of interest. We trust you have your own hectic agendas. So join us as we hoist the ever-present cup of stimulation and attack the to-do list. Our choice today is cinnamon hazelnut. Meanwhile, have a grand day, everyone, and do stay in touch. …

A small but growing number of state Medicaid programs are negotiating discounts for a high-priced weight-loss drug in a bid to hold down costs as low-income patients increasingly seek obesity treatment, Bloomberg Law tells us. Nine states from California to Rhode Island have begun to cover expensive, next-generation weight-loss drugs like Novo Nordisk’s Wegovy on their Medicaid preferred drug lists. Preferred drug status allows patients to receive coverage for weight-loss drugs without the need to undergo step therapy, where patients are required to try less expensive and potentially less efficacious drugs before receiving their original drug of choice.

Shortages of an Eli Lilly diabetes drug, Mounjaro, have expanded to include all of the higher doses, showing just how strong demand is for the drug before it even gets formal approval for use in obesity, Bloomberg News notes. Just last month, U.S. regulators said that three of the higher doses of the Lilly drug were experiencing “intermittent backorders” through July due to increased demand. The latest update adds a fourth dose to that list and extends issues with another, higher-dose option through September, according to the U.S. Food and Drug Administration website. Only the two lowest doses of the drug remain fully available.

STAT+ Exclusive Story