Jamy Ard: Shortsighted decision on obesity meds fails state workers

Tina, a North Carolina state employee, has struggled with obesity since her mid-20s. After her son was born, her weight spiraled — high blood pressure, pre-diabetes and a family history of diabetes threatened her health. When she learned that the North Carolina State Health Plan would no longer cover medications used for obesity management, her hope for better health and quality of life was crushed.

Earlier this year, the NCSHP voted to discontinue coverage for these critical medications. While the board cited short-term financial concerns and differential pricing between U.S.-based and European medicines as its rationale, it failed to prioritize the health and well-being of people living with obesity and health improvements that obesity medicines can offer state employees and their dependents. This decision is a significant step backward in the fight to improve the lives of people with obesity, and it is a clear example of how weight bias influences policy decisions in harmful ways.

Obesity isn’t just a personal struggle; it’s a widespread issue that affects millions of people. More than 34% of adults in North Carolina live with obesity, and more than 35% of adults are overweight. Treating obesity early can prevent life-threatening conditions such as heart disease, stroke, type 2 diabetes and several cancers. The long-term costs of untreated obesity will far outweigh any immediate savings the state might realize.

I recognize that the NCSHP was not the only party involved in the ultimate removal of coverage for these crucial medications. All actors in the market, including drug manufacturers, pharmacy benefit managers and health insurance plan decision-makers, must change practices to ensure meaningful access to obesity care. Coverage decisions should be made in the best interest of a person’s health and well-being. While I agree that the newest generation of obesity medications are too expensive, simply leaving patients with no options is not reasonable.

The consequences are already being felt by workers across the state. Tina, like many others, knows that these medications could prevent serious health issues down the line.

“It’s a shame that even with a prescription, they are unattainable,” she says. Her frustration echoes that of thousands of state employees who are being denied access to the care they need.

As an obesity expert, I am extremely disappointed in the negotiation process that led to NCSHP’s decision to drop coverage of all medicines for obesity management for state employees. In the three months since this vote, the board, pharmacy benefits manager and obesity medication manufacturers have all dug in their heels, leaving state employees without a number of proven, effective treatments.

NCSHP is penalizing patients affected by obesity, especially given that no FDA-approved medications for obesity are covered. Is the state dropping coverage for other expensive drug classes that treat other diseases? The answer is no, and that fact should remind our leaders that everyone deserves access to comprehensive care to improve their health and quality of life.

This isn’t just a state issue; it’s a warning sign for the entire country. If North Carolina can disregard the health of its workers in favor of short-term financial gain, what’s to stop other states from following suit? The ripple effects of this decision could undermine efforts to treat obesity nationwide.

Obesity is a complex, chronic disease that requires serious action, access to science-based treatment and comprehensive obesity care to improve quality of life and health. People affected by obesity need equitable access to effective treatment options in the same way as those with other chronic diseases. We can only make this happen when drug manufacturers, pharmacy benefit managers and health insurance plan decision-makers work toward the best interest of plan members and avoid the bias-driven tendency to focus solely on their bottom line.

It’s time for all parties involved to come back to the negotiating table. They must find a solution that prioritizes the health and well-being of state employees over profit margins. North Carolina cannot afford to abandon its workers to a life of preventable chronic illness. The health of our workforce — and the future of our state — depends on it.