MEDICAID: Taxpayers Might Pay Triple For Diabetes Drugs In 2026
In 2023, Medicaid gross spending on 10 selected diabetes and two selected weight loss drugs cost federal taxpayers more than $9 billion in 2023, an increase of 540 percent from 2019.
This is according to an audit that the U.S. Department of Health and Human Services’ Office of Inspector General published this month.
In 2019, these same drugs cost taxpayers $1.5 billion, according to the audit. This substantial increase, auditors said, could put a big dent in the Medicaid program. In recent years, Medicaid has seen a substantial increase in the use of certain diabetes and weight loss drugs.
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“During this same time period, utilization of the 12 drugs increased by 350 percent, totaling 11 million claims in 2023,” auditors wrote.
“We estimated that Medicaid gross spending on these 12 drugs accounted for approximately 9 percent of all Medicaid spending on covered outpatient prescription drugs in 2023. If the annual percentage increase in gross spending on the 12 selected drugs continued at a rate of 47 percent, the smallest annual rate of increase that we observed during our audit period, it could potentially amount to over $29 billion in Medicaid spending on these drugs in 2026.”
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Certain diabetes drugs initially approved by the Food and Drug Administration (FDA) to help control blood sugar levels for individuals with type 2 diabetes are known as highly effective weight loss agents.
Similar drugs were later approved by the FDA specifically for weight loss. Most state Medicaid agencies cover the diabetes drugs to treat diabetes in Medicaid enrollees. Most states, however, do not cover the weight loss drugs or the diabetes drugs if prescribed for weight loss.
In their report, auditors cited drugs such as Ozempic, Trulicity, Victoza, and Bydureon, among many others.
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The Medicaid program provides medical assistance to certain low-income individuals and individuals with disabilities. The federal and state governments jointly fund and administer the Medicaid program.
“More than 38 million Americans have diabetes, and one in five people with diabetes do not know they have diabetes,” auditors wrote.
“In the last 20 years, the number of adults with diabetes has more than doubled.”
Special thanks to Warhammer’s Wife proofreading this story before publication to make certain there were no misspellings, grammatical errors or other embarrassing mistakes and/or typos. Follow Warhammer on Twitter @Real_Warhammer
