Anita Blanchard had been caught in the cycle of losing and regaining the same 20 pounds over and over again. Like many people, she came to a frustrating realization—traditional diets just didn’t work for her. But when Anita, a professor at the University of North Carolina-Charlotte, heard about a medication called Ozempic that could help with weight loss, she was eager to give it a shot.
Ozempic, originally designed to treat Type 2 diabetes, had become a game-changer for weight loss. Anita’s health insurance covered most of the cost, leaving her with just a $25 copay. Within seven months, she shed 45 pounds, lowered her blood pressure and cholesterol, and experienced a significant shift in her mental health.
“It quieted the constant chatter about food in my head,” Anita shared. “I felt less anxious, and my drinking habits changed too. I could have just one glass of wine and stop there—it was amazing.”
But there was a catch. Anita wasn’t the only one benefiting from the drug. Thousands of state employees on the North Carolina health plan were also turning to Ozempic and similar medications. As the pounds dropped, the costs skyrocketed. These drugs ended up consuming a staggering 10% of the state’s prescription drug budget, costing more than cancer and chemotherapy treatments combined. In total, the state was bracing for a $170 million bill this year, and over the next six years, those costs were projected to top $1 billion.
Faced with this financial burden, the state’s health plan made a tough call. Starting in April, it stopped covering these medications for weight loss, though it still paid for them for diabetes management. That left state employees like Anita with a heartbreaking choice—stop taking the medication or shell out $1,200 a month out of pocket.
“They know diets aren’t a lasting solution for most people, yet they’ve taken away something that truly works,” Anita said. “It’s all about saving money, not about helping people live healthier lives.”
Meanwhile, another branch of North Carolina’s government decided to take a different approach. Medicaid, the program for low-income residents, began covering these medications for weight loss in August. Medicaid serves over 2 million people in the state, many of whom are disproportionately affected by obesity and related health issues.
And North Carolina isn’t alone in facing this dilemma. Other states are wrestling with the high price tags of these drugs too. West Virginia canceled a pilot program for its state employees, and in Connecticut, employees prescribed the medication must join a lifestyle management program.
On the federal level, a big shift could be on the horizon. The outgoing Biden administration has proposed expanding Medicaid and Medicare coverage to include obesity treatments like Ozempic. If approved, it could cost the federal government $40 billion over ten years. But this decision won’t kick in until after President-elect Donald Trump takes office in January, leaving room for potential changes.
So, why are these drugs so expensive? Medications like Ozempic, Wegovy, and Trulicity are part of a class called GLP-1 agonists. They work by helping people feel full faster, reducing appetite, and even slowing digestion. For those who take them, the results can be life-changing—but they have to stay on the medication to maintain the benefits. That means ongoing, and often hefty, costs.
Experts argue that these drugs could save money in the long run by reducing obesity-related health problems, such as heart disease and diabetes. Medicaid officials in North Carolina agree, saying it’s worth the investment. The state spends nearly a billion dollars annually on diseases tied to obesity. Cutting even a small percentage of those costs could make a big difference.
But for people like Anita, who don’t qualify for Medicaid, the current system feels unfair. “It’s so frustrating,” she said. “Why should I be left behind just because of where I work?”
Doctors and researchers are calling for a shift in how obesity is treated and viewed. They argue that obesity should be seen as a chronic condition requiring medical treatment, not as a personal failing. “We need to remove the stigma,” said Dr. Nishant Shah, a cardiologist at Duke University. “Making these drugs more accessible could change lives.”
Anita’s story doesn’t have a perfect ending. When her insurance stopped covering Ozempic, she found a workaround. A doctor prescribed her a non-branded version from a compounding pharmacy for $225 a month. It’s less effective, but for now, it’s a compromise she can live with.
“I can manage this cost,” Anita said, “but I just wish more people had the same chance to feel as good as I do.”
