A Republican state lawmaker who lost hundreds of pounds through a popular weight loss drug said he's concerned that state health insurance coverage for GLP-1 drugs for weight loss will end next week. He said he has a bill to help them, but it won't pass before they lose that coverage.
Rep. Josh Williams (R-Sylvania Twp.) said he knows first-hand the value of GLP-1 drugs such as Wegovy or Ozempic. He said he suffered a back injury years ago and was 458 pounds at his heaviest. He said an inability to exercise and opioid prescription use contributed to that weight gain.
"I've tried everything under the sun. I've had weight loss surgery. I've tried medication that was prescribed by Cleveland Clinic. Some of them were very harmful drugs," Williams said. "Now I've tried GLP-1s and they were successful and I am able to transition off of them."
Williams said he's been taking the GLP-1 drug Wegovy, and in the last two years he's dropped down to 192 pounds. He's now transitioning off the drug.
But some 2,000 state employees who have access to GLP-1s through their health insurance will lose that coverage soon, at the order of the Department of Administrative Services. DAS said the drugs are costing the state around $45 million a year. The agency won't cover GLP-1s for weight loss beginning July 1, though employees currently on those medications will be covered through the end of the year.
Williams said his legislation would allow state employees to buy GLP-1 drugs directly from their manufacturers at the lower rate given to customers without insurance, and DAS would issue rebates back to those employees. In the first year, costs would be covered at 100%, up to $500 a month, and at 50% in the second year, up to $200 a month. Williams said his bill would cost DAS between $9 million and $12 million a year. Rep. Dontavius Jarrells (D-Columbus) is a joint sponsor.
"I think it's a conservative and creative way to reduce costs of prescriptions here in the state of Ohio," Williams said. "This will be the first piece of legislation in the country that will provide a rebate from the government to their employees for direct to consumer models."
Though DAS said state employees currently taking GLP-1s will continue to be covered through the end of this year, Williams said he was frustrated that DAS didn't delay the order while he worked toward a resolution, calling that "reckless".
Williams also said lawmakers are looking at how to save on the costs of pharmacy benefit managers. Those are the middlemen in the state drug plans that Williams said often drive the cost of drugs much higher for the state. He suggested legislation could be coming to further reduce PBMs' role in state health care plans.
