Diabetes, weight loss drugs cause spike in spending, utilization
By HME News Staff
Updated 9:07 AM CST, Mon December 23, 2024
WASHINGTON – Medicaid spending on 10 selected diabetes and two selected weight loss drugs totaled more than $9 billion in 2023, a 540% increase compared to 2019, according to a new Data Brief from the Office of Inspector General.
“This substantial increase could have a financial impact on the Medicaid program,” the brief states. “Information in this data brief may be beneficial to CMS and State Medicaid agencies when developing future program guidance related to these drugs.” Other findings in the brief:
- During this same time period, utilization of the 12 drugs increased by 350%, totaling 11 million claims in 2023.
- We estimated that Medicaid gross spending on the 12 selected drugs accounted for approximately 9% of Medicaid spending on covered outpatient prescription drugs in 2023.
- We also estimated that Medicaid gross spending on the 12 selected drugs could potentially amount to over $29 billion in 2026.
The brief did not contain recommendations. CMS did not provide written comments but it did furnish technical comments, which the OIG addressed.
Read the brief here.
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