Op-Ed: NC Medicaid must continue to cover anti-obesity medication
By Robbie Holland
Obesity is one of the most dangerous chronic diseases affecting North Carolina. Not only does the disease have a significant physical impact through its link to over 230 other serious conditions, but its fiscal impact is also costing our state billions in healthcare costs every year.
The data paints a stark picture: 45 percent of North Carolinians live with obesity. Rates of other obesity-related chronic diseases like cardiovascular disease, diabetes, hypertension, and arthritis all outpace the national average; and it costs our state $17 billion a year between healthcare costs and economic loss from lessened worker productivity.
This is an issue that must be addressed head on, and with big solutions that match the scale of the problem.
Fortunately, in August 2024, NC Medicaid announced that it would become one of slightly more than a dozen states to cover FDA-approved anti-obesity medications (AOMs) for the treatment of obesity. With obesity costing NC Medicaid nearly $1 billion annually, this was the right move – and allowed us to fully unlock the power of these life- and cost-saving medications.
Now, however, with the State Legislature and Governor finalizing the budget over the coming weeks, there has been discussion of ending this coverage. While I understand the desire to reduce spending in these challenging fiscal times, eliminating coverage is short-term thinking that will cost North Carolina far more in the long run.
Expanding access to AOMs represents one of the most cost-effective investments the state can make. Study after study have shown the health benefits. From a 44 percent reduction in the risk of hospitalizations caused by cardiovascular disease in the first two years of treatment to a myriad of others including improved sleep apnea, a lower risk of diabetes or kidney disease, and more, it is clear that AOMs are highly effective.
On the fiscal side of things, AOMs have also been shown to lead to a seven percent reduction in medical costs in that same two-year timeframe. The reduction of excess weight and in turn a reduced risk of comorbidities lowers spending in emergency room care, inpatient stays, and other prescriptions. Longer term, savings are estimated to range from $6,700 to $7,100 over 10 years per person treated.
But this fiscal impact extends beyond just healthcare costs. The indirect costs of obesity, including workforce disruptions, costs the country more than $1.24 trillion annually. And in the next decade, moving in the wrong direction on obesity care will cost the U.S. as much as $11.9 trillion in lost GDP from labor supply shrinkage.
When workers struggle with obesity-related illnesses, they miss more workdays, leading to , decreased productivity, and higher costs for employers. A healthier workforce means a stronger economy for North Carolina.
This is about the long-term future of North Carolina. It is about preventing far costlier healthcare interventions down the road. With AOM coverage under NC Medicaid, the state can prevent heart attacks, strokes, reduce the risk of diabetes and kidney disease, and give residents their lives back. All the while they can save substantially from reduced healthcare costs in the years to come.
Maintaining coverage of AOMs for NC Medicaid enrollees is a prime example of smart policy. North Carolina taxpayers deserve policies that reduce long-term costs while improving health outcomes for our most vulnerable residents.
Investing in prevention now will save billions later, and help lead to healthier, more productive North Carolina for generations to come.
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