Weight loss drugs like Ozempic could soon be in reach

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By Lindsey Banks

At Carolina Family Healthcare in Charlotte, family physician Dimitrios Hondros has seen firsthand the life-changing benefits of weight loss drugs like Ozempic and Wegovy.

Patients not only lose weight but also often see improvements in blood pressure, cholesterol and blood sugar — factors that reduce their risk for heart disease and diabetes.

Yet Hondros estimates that 30 percent to 40 percent of his patients who could benefit from these medications aren’t taking them. They simply can’t afford the high price tag, and health insurance coverage is limited.

The medications, called GLP-1s, can cost roughly $12,000 a year out-of-pocket. While most health insurance plans cover them for diabetes, coverage for obesity alone is far less common.

But with prices starting to fall and policies under review, insurance experts say that could soon change.

Originally developed for diabetes, GLP-1s soon became recognized for their ability to help patients lose 15 percent or more of their body weight through weekly injections. They have also shown broader benefits like better heart health, reduced symptoms of sleep apnea and enhanced liver and kidney function.

Hondros said that means healthcare costs for patients using GLP-1s down the road could be lower for insurance companies.

“Just 3 percent to 5 percent weight loss helps drive down the total cost of healthcare, because you’re improving other chronic disease outcomes,” said Hondros, who served as president of the North Carolina Academy of Family Physicians in 2022 and has been fighting for broader access to GLP-1s on the state level for many years.

The drugs can also help prevent devastating health outcomes, Hondros said. One of his patients, who couldn’t afford the medication, ended up in a wheelchair because of severe arthritis tied to her weight, he said.

Another died of a massive heart attack — an event that might have been prevented with access to weight loss medication, he said.

Who covers GLP-1s for weight loss?

North Carolina is one of just 13 states whose Medicaid program covers GLP-1s for weight loss, meaning the drugs are available to the state’s lowest-income residents.

Meanwhile, 750,000 state employees, including teachers, lost access in 2024 when the state health plan dropped coverage due to rising demand and cost. Dale Folwell, the state treasurer at the time, said the state was on track to spend $170M a year to cover 23,000 members taking the drugs.

For many patients, the deciding factor is employer-sponsored insurance. About 75 percent of working adults in the U.S. receive their insurance through their employer, according to a 2023 study from KFF, a nonprofit that focuses on health policy issues in the U.S.

In Charlotte, it’s unclear how many employers offer GLP-1 coverage.

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