CHARLESTON, S.C. — Page Campbell, a 40-year-old single mother, decided to try Wegovy, an injectable prescription drug, to help lose weight before her planned bariatric surgery. She has struggled with her weight for years and welcomed any chance to improve her health.
After starting Wegovy in early April, Campbell said she had no side effects like nausea or bowel issues. She does not own a scale, so she was unsure how much weight she had lost since her last doctor visit when she weighed 314 pounds. Still, she felt hopeful because she was also eating better and exercising regularly.
Wegovy is part of a class of expensive drugs called GLP-1 agonists that have changed obesity treatment. These drugs offer hope to many people who have tried other methods without success.
Campbell gained access to Wegovy thanks to South Carolina Medicaid’s decision in late 2024 to cover weight loss medications. However, many other states and insurers do not cover these drugs due to their high cost, leaving millions without access.
A report from KFF Health News found that only 14 states, including South Carolina, cover GLP-1s for obesity through Medicaid. Many states are hesitant to add expensive new benefits as they face possible federal budget cuts.
The federal government also does not cover GLP-1 drugs for obesity through Medicare. A proposed rule that would have expanded coverage was recently withdrawn by the administration.
Even in states where Medicaid covers the drugs, strict rules limit access. South Carolina requires patients to prove they have tried diet and nutrition counseling and a low-calorie diet for six months before approving Wegovy.
Patients must also show progress, such as losing at least 5% of their body weight, to continue receiving coverage. The approval process is complex and many people may not complete it.
The high cost is a major challenge. Wegovy’s price was recently reduced from $650 to $499 per month for those paying out of pocket. However, insurance costs can be much higher, and patients often need the drug long-term.
Some states are rolling back coverage to save money. California plans to end Medicaid coverage of GLP-1s for weight loss next year to save hundreds of millions annually. North Carolina also cut coverage for state employees despite starting Medicaid coverage recently.
South Carolina Medicaid expects to spend about $10 million annually on these drugs, shared between state and federal funds.
Health officials say these drugs are promising but costly. South Carolina’s public health efforts focus more on promoting exercise and healthy eating through community programs rather than drug treatment.
Page Campbell is using a full approach. Along with Wegovy injections, she is focused on nutrition, exercise, and recently underwent weight loss surgery.
“Weight loss is my biggest goal,” she said. “It’s one more thing that’s going to help me get there.”
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