The outgoing Biden administration is proposing to have popular weight-loss drugs like Wegovy or Zepbound covered by Medicare or Medicaid, and the director of WVU Medicine’s medical weight management program says making such drugs more widely available to millions of Americans with obesity shows significant promise.

Dr. Laura Davisson is advocating for more work to demonstrate the health effects as well as longer-term financial effects of the weight-loss drugs. Davisson led the Morgantown site of a pilot program to treat people covered under the Public Employees Insurance Agency for obesity.

The pilot program was small and it offered comprehensive care, including nutrition counseling, exercise guidance, frequent follow-ups and sometimes GLP-1 medications. Those are glucagon-like peptide receptor agents — a class of medications that treat Type 2 diabetes and obesity.

“Our results in Morgantown of approximately 500 PEIA patients were remarkable: patients lost an average of 15% of their body weight and improved key health markers like blood pressure, cholesterol, and hemoglobin A1c,” Davisson said.

West Virginia’s Public Employees Insurance Agency ran the pilot program just for a short time to support members with the costs of drugs to fight obesity, where the state’s statistics rank worst in the nation. 

But, like other states, West Virginia was challenged by the expense of the drugs. PEIA paused the pilot program this past March 15, honoring existing pre-authorizations through June 30, the end of the fiscal year, or through the term of the authorization, whichever was longer.

The drugs like Wegovy and Zepbound may be used to treat obesity or diabetes — or both — but some insurers including most Medicaid programs only cover them when they are used to manage diabetes. The question for states as they try to consider public interest is how much to expand access for weight loss.

Even though West Virginia’s pilot program for PEIA was limited to about 1,000 patients statewide, the expense was characterized as adding  up to about $1.3 million a month. If the program were expanded to include up to 10,000 people as intended, the program could end up costing $150 million a year.

If the federal government takes on coverage, it would cost taxpayers as much as $35 billion over the next decade. The rule would not be finalized until January, days after President-elect Donald Trump takes office, and the incoming administration’s position is not yet clear.

Senator Shelley Moore Capito, R-W.Va., supports the idea of covering anti-obesity medications, said Kelley Moore, spokeswoman for the senator’s office. Capito has indicated she will take a look at the proposal and will work with the incoming administration.

“Senator Capito has long supported the idea of covering anti-obesity medications,” Moore said. “She looks forward to reviewing this proposal and working with the incoming Trump administration to create policies that lead to healthy communities.”

Gov. Jim Justice weighed the pros and cons of the federal proposal last week during a regular administration briefing.

Justice gave a personal touch when he acknowledged he has used the same drugs to lose weight.

“I am a recipient right now of Ozempic, and I’m trying every way that I can to lose weight,” Justice said. “I’ve been able to lose 30 or 40 pounds, maybe even 50 pounds.”

Justice, who will take on a new role as U.S. senator in January, expressed support for the kind of health benefits that can come when overweight people shed pounds but he also took note of the up front expense of the drugs.

“I don’t know how we go about expanding access from the standpoint of the cost, but we have got to make it sustainable. We’ve got to make that part a big part of this whole puzzle,” Justice said.

“But for all I know about these drugs, they are beneficial in many different ways. But the net-net of the whole thing is, at the end of the rainbow, it’ll save us money. It’ll save us money.”

On the whole, Justice said he supports expanding the weight loss drugs to access for all. “The battleground will be the cost, how we’re going to handle the cost,” he said.

Davisson, who leads the WVU weight loss program, suggested that as PEIA is at the center of a broader public policy discussion that its own pilot program for weight loss drugs should be resumed to demonstrate the potential health benefits.

Long-term, Davisson agreed that the weight loss program could help overall costs subside.

“I suspect we will learn that GLP1s could be part of the solution to PEIA’s problems, which would be consistent with the opinion Governor Justice expressed during his briefing,” Davisson said.

“Given the governor’s view and the fact that this pilot aligns with the kind of forward-thinking model that could be a model for other plans facing the rising costs of GLP-1 medications for obesity treatment, I hope that PEIA will reinstate it so that PEIA and West Virginia can be leaders in this area.”