Oh boy, do we have a funny story for you. So apparently, the insurance plan for North Carolina state employees was paying for 2,800 people to take weight-loss drugs. Yeah, you heard that right. They were shelling out big bucks to help people shed a few pounds. But wait, it gets better (or worse, depending on how you look at it).
Last year, the plan paid for nearly 25,000 people to take these magic weight-loss drugs. That’s right, TWENTY-FIVE THOUSAND. And guess how much it cost them? A cool $100 million. Now, I don’t know about you, but that seems like an insane amount of money to spend on something as trivial as weight lossSponsored Product. Must be nice to have an insurance plan that covers your desire to fit into those skinny jeans.
But hey, who could have seen this coming, right? Certainly not Dale Folwell, the state treasurer, whose office runs the health plan. He said, and I quote, “This is something we never anticipated.” Really, Dale? You never anticipated that people would want to lose weight and that they would rely on your insurance plan to foot the bill? Shocking, I know.
Well, after realizing that they were hemorrhaging money faster than a dieter during cheat day, the health plan’s governing board decided to put an end to all coverage of weight-loss medications. No more magic pills for you, fatty! Unless, of course, you have diabetes. Then you’re still in luck. They’ll cover the medications for you. Because apparently, being overweight AND having diabetes is a winning combination.
Now, you might be wondering why these weight-loss drugs are so popular. Well, it turns out they actually work! Who would’ve thunk it? Research suggests that these medications can help prevent heart attacks and strokes, which can lead to some hefty hospital bills. So hey, maybe there’s a method to this madness.
But for the employers and health plans that have to foot the bill, the cost is just too damn high. The University of Texas system and the hospital chain Ascension have already stopped paying for these drugs for their workers. And those that continue to cover them are imposing new restrictions to cut costs. The Mayo Clinic, for example, will now only provide a lifetime benefit of $20,000 for the drugs. That should be enough to get you through a few months, right?
But let’s get back to our friends in North Carolina. The state health plan is in some serious financial distress. Its cash position declined by a whopping $250 million last year. Ouch. So the governing board decided to do what any responsible organization would do: cut off funding for weight-loss drugs. After all, you can’t have state employees losing weight AND money at the same time. It’s just not good for the budget.
Starting on April 1 (and no, this isn’t an April Fool’s joke), coverage for weight-loss medications will cease. If you want to keep taking these drugs, you better start saving up, because they can cost over $16,000 a year without insurance coverage. And let’s be real, the average state employee’s salary isn’t exactly rolling in the dough. Good luck affording those pills when you can barely afford your mortgage.
Now, you might be wondering why they didn’t just place some restrictions on who could get these drugs in order to cut costs. Well, it turns out they would lose $54 million in discounts from the drugs’ manufacturers if they did that. So I guess saving money just isn’t in the cards for North Carolina.
But don’t worry, folks. The state treasurer, Dale Folwell, is on the case. He’s been outspoken about the plan’s unsustainable spending on weight-loss drugs. He even compared the cost to a 0.5 percent pay raise for all state employees. How’s that for perspective? He’s also called out Novo Nordisk, the manufacturer of one of the drugs, for what he calls price gouging. I mean, $800 per month per patient? That’s just plain robbery.
Of course, Novo Nordisk wasn’t too happy about the decision to end coverage. They called it “irresponsible” and said they had been working with the state health plan officials to address concerns about cost. But hey, who needs insurers or bureaucrats messing with their medically driven decisions, right? They should just keep charging whatever they want and let the rest of us deal with the consequences.
It’s worth mentioning that Novo Nordisk manufactures and packages their weight-loss drug, Wegovy, in Clayton, North Carolina. I know, talk about adding insult to injury. The state is literally helping to manufacture a drug that they can’t afford to cover. It’s like a cruel joke.
But hey, at least Novo Nordisk employs over 2,500 North Carolinians and has poured a whopping $5 billion into the state. So I guess we can all sleep soundly knowing that they’re supporting the economy while bankrupting the health plan. Thanks, guys!
In the end, the board voted 4 to 3 to end coverage of the weight-loss drugs. It was a tough decision, no doubt. Wayne Fish, one of the trustees who voted against it, said it was a balance between solvency and people’s lives. Yeah, because who needs solvency when you can have a few extra pounds, am I right?
So there you have it, folks. The wacky world of weight-loss drugs and insurance plans. Who knew shedding a few pounds could cost so much? But hey, at least we can all laugh (or cry) about it together. And maybe, just maybe, this story will be a cautionary tale for other health plans out there. Probably not, but we can dream.
Buried in Wegovy Costs, North Carolina Will Stop Paying for Obesity Drugs