Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
Guidance Document Change: This is a new form used to determine whether DMAS will cover certain weight loss drugs. (This process is called service authorization.)
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9/14/23  8:44 pm
Commenter: Greg McClanahan

Wegovy access

I wanted to state that I believe that the current proposal for access to GLP-1s is overly restrictive and has to potential to limit access to a significant portion of patients that would greatly benefit from the medication. Obesity, and often as resulting in diabetes, is a significant challenge in the Medicaid population. My experience is that  ability to treat with the current prior authorization process and guidelines provides this population with the potential to significantly impact their quality of life while also decreasing the risk of diabetes and the comorbidities that go along with it. The timeline of only 6 months seems overly restrictive. Speaking from personal use of the progress. I have been on Wegovy for over 12 months and continue to see additional weight loss and also movement of blood sugar from prediabetic to normal levels and a continued . The majority of alternative products tend to increase blood pressure which tends to go along with obesity. The proposed steps for approval are also prohibitive and has the potential to decrease access due to the steps required for approval. The new proposal has the appearance of an unfunded mandate that will increase the time both pharmacists and physicians must spend to get the product approved without an increase in reimbursement which again will limit this populations access to a beneficial medication.

CommentID: 220335