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. 2025 Jul 16:12:1537181.
doi: 10.3389/fmed.2025.1537181. eCollection 2025.

Spending, utilization, and price trends for anti-obesity medications in U.S. Medicaid programs: an empirical analysis from 1999 to 2023

Abdulrahman A Alsuhibani  1 , Marwan A Alrasheed  2 , Ibrahim S Alhomoud  1 , Saud Alsahali  1 , Ziyad S Almalki  3 , Jeff Jianfei Guo  4
Affiliations

Spending, utilization, and price trends for anti-obesity medications in U.S. Medicaid programs: an empirical analysis from 1999 to 2023

Abdulrahman A Alsuhibani et al. Front Med (Lausanne). .

Abstract

Background: Obesity poses a significant public health and economic challenge in the United States (U.S.), with rising prevalence, particularly among individuals enrolled in Medicaid-the nation's public health insurance program for low-income populations. Anti-obesity medications (AOMs) have become integral to managing obesity, but trends in their utilization and spending within Medicaid remain underexplored.

Objective: To examine Medicaid's utilization, reimbursement, and price trends for AOMs from 1999 to 2023.

Methods: A retrospective analysis assessing the utilization, reimbursement, and pricing of older and newer AOMs. Yearly prescription numbers and reimbursement were calculated for seven AOMs billed through Medicaid between 1999 and 2023. The average expenditure per prescription was used as an indicator of drug pricing.

Results: AOM prescriptions rose from 13,855 in 1999 to 938,663 in 2023, a 6,674% increase. Spending surged by over 77,805,466% due to the introduction of newer, more effective medications, including Wegovy and tirzepatide. The largest share of the market growth in 2023 was driven by these medications.

Conclusion: The significant increase in AOM utilization and spending highlights the growing burden of obesity on Medicaid, emphasizing the need for policy measures to manage rising costs and ensure equitable access to treatment.

Keywords: COVID-19; Medicaid; obesity; pandemic; spending; trends; utilization.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Medicaid utilization (number of prescriptions) of anti-obesity medications from 1999 to 2023.
Figure 2
Figure 2
Medicaid spending (reimbursement) of anti-obesity medications from 1999 to 2023 (US$).
Figure 3
Figure 3
Medicaid utilization (number of prescriptions) market share for anti-obesity medications from 1999 to 2023.
Figure 4
Figure 4
Medicaid spending (reimbursement) market share for anti-obesity medications from 1999 to 2023 (US$).
Figure 5
Figure 5
Joinpoint regression for the tirzepatide, Wegovy, and Saxenda AOMs utilization in CMS.
Figure 6
Figure 6
Joinpoint regression for the Qsymia, and Contrave AOMs reimbursement in CMS.
Figure 7
Figure 7
Joinpoint regression for the tirzepatide, and Wegovy AOMs price in CMS.
See this image and copyright information in PMC

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