NJ Spotlight News
Health plans consider cost of pricey obesity drugs
Clip: 12/4/2024 | 5m 2sVideo has Closed Captions
Almost a third of NJ's population struggles with chronic obesity
In New Jersey, almost 29% of the population struggles with chronic obesity, but New Jersey is among a majority of states where Medicaid doesn't cover the drug specifically for weight control. President Joe Biden recently called on more states to open up the coverage for weight control.
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NJ Spotlight News is a local public television program presented by THIRTEEN PBS
NJ Spotlight News
Health plans consider cost of pricey obesity drugs
Clip: 12/4/2024 | 5m 2sVideo has Closed Captions
In New Jersey, almost 29% of the population struggles with chronic obesity, but New Jersey is among a majority of states where Medicaid doesn't cover the drug specifically for weight control. President Joe Biden recently called on more states to open up the coverage for weight control.
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Providing Support for PBS.org
Learn Moreabout PBS online sponsorshipWeight loss drugs have surged in popularity in the US over the last few years.
Montero OHS MPH and will go.
They are heavily sought after, but they come at a cost for some in New Jersey.
The Biden administration announced last week plans to require Medicare and Medicaid to offer coverage for these medications for people seeking obesity treatment.
This could provide an answer to many struggling to shed a few pounds.
And as senior correspondent Brenda Flanagan reports.
There are new efforts here in the state to cover these weight loss drugs.
Said.
Janet Tagliabue's a professional dog walker, so she gets lots of exercise escorting clients around Hasbrouck Heights.
But she still couldn't lose weight.
Meanwhile, her blood pressure and the risk of stroke kept rising.
So her doctor prescribed the popular weight loss drug Wegovy.
I really just want to feel better and more confident.
I don't like the way that I'm looking right now, and I look back at old pictures and think like, wow, like what happened?
You know?
So really, I just want to get back on track.
We go V and similar injectable weight loss drugs called GLP one can cost more than a thousand bucks a month.
Despite that, they're often backordered due to high demand.
Janet can afford it only because she's covered by her parent's health insurance.
So I did get rather lucky if I like I said, if I had to pay out of pocket for it, I definitely wouldn't have.
In New Jersey, almost 29% of the population struggles with chronic obesity.
But New Jersey is not one of the 13 or so states where folks on Medicaid can get GLP one meds for weight control.
Right now, Medicare and Medicaid I believe do cover GLP one drugs.
If someone's a diabetic or if someone has heart disease, it's not covered simply for people who want to lose weight.
So it's an important distinction.
I would make sort of an ethical argument that, you know, we would be gatekeeping, a really good life saving drug for a lot of these people by not making that available.
Dr. Kunal Shah runs a weight loss clinic at Rutgers.
He supports the Biden administration's recent call for Medicare and Medicaid to cover GLP one's for weight loss and disagrees with Trump.
Health and Human Services nominee RFK Jr's assertion that three organic meals a day can solve the nation's obesity crisis.
People who are on Medicaid, oftentimes those are people who are low income and they don't have access to healthy foods.
They can't just drive into Whole Foods and buy organic food for their families.
They're often working.
Two or three jobs have to get frozen meals, which are not healthy.
And so a lot of the oh, just diet and exercise is easier said than done for a lot of these people.
I've always struggled with weight, you know, from being know midnights the first seven years of my career.
You just lose your metabolism.
I'm on these drugs.
I lost £80.
Kevin Lyons is a believer.
He's on Mom Gero and says its maker, Eli Lilly, sent reps to lobby him as executive director of Jersey's Police Benevolent Association.
Lyons predicts his 33,000 active members will gravitate towards the new weight loss drugs, even though New Jersey's health benefits program for local and county workers will get slammed by a 16% premium hike next year.
Lyons says eliminating coverage isn't worth the savings.
It was 1.6% on the overall rate.
That's medical and prescription that it would save if we eliminated GOP ones from weight loss.
To me, that just would just not work this week.
You know, when you talk about even with a 16% rate increase.
A recent study reports drug spend for weight loss drugs increased 160%.
We go we ranked first Ozempic Mangano and Trulicity ranked in the top ten in the state benefits plan last year in response to double digit premium hikes.
Some municipalities, like Newark, are opting for alternative health plans.
But policy experts point to other factors.
It's not just the cost of weight loss drugs, it's the cost of specialty medicine, as an example of measures considered a specialty drug.
And that will cost a planned approximately $7,000 a month for that drug.
A bill sponsored by Senator Joe Vitale would require New Jersey State health plans and Medicaid to cover GOP ones for patients who have obesity related health problems that have not been mitigated by diet and exercise alone.
Jana agrees.
I don't think it should be over-the-counter.
But I think, you know, it should be easier for people to get their hands on and not expensive.
She just started treatment a month ago and hopes to see results soon in Hasbrouck Heights.
I'm Brenda Flanagan, NJ.
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