Novo Nordisk's Battle to Keep Medicaid Coverage for Obesity Drug Wegovy Amid Rising Costs

Novo Nordisk is actively working to retain Medicaid coverage for its obesity drug, Wegovy, in the face of financial pressures bearing down on several U.S. states. Documents, company emails, and insights from lawmakers and advocates suggest Novo's lobbying has been pivotal in persuading 14 states to offer Wegovy under Medicaid. The Danish company argues that such coverage could ultimately lead to savings in healthcare costs by reducing obesity-related conditions like diabetes and heart disease. However, rising demand and costs have led states like California, North Carolina, Pennsylvania, and Connecticut to rethink their stance on weight-loss drug coverage.

With nearly 40% of adults in Medicaid affected by obesity, changes to drug access could have a profound financial impact. Novo's tactics to maintain support include mobilizing community groups and health professionals to advocate for continued coverage, as reported by Reuters. This comes amid a loss in its market share to competitor Eli Lilly, leading to a shakeup in Novo's executive ranks and lowered sales projections. California's Medicaid program, one of the first to cover Wegovy, exemplifies the issue. It spent nearly $1 billion on prescriptions, resulting in state officials planning to pull coverage entirely by 2026.

Amid these challenges, Novo's approach includes leveraging alliances with groups like the Alliance for Women's Health and Prevention and even nurturing grassroots advocacy. In North Carolina, employees formed an obesity society to oppose cuts. Critics argue that Novo and companies like it should consider lowering drug prices to expand access, echoing sentiments from public figures like Senator Bernie Sanders. While Novo states its business practices are ethical and within legal bounds, the controversy highlights the complex dynamics between pharmaceutical lobbying and public health policy.