State health plan cites surge in GLP‑1 prescriptions; pharmacy spending jumps

Officials for the Missouri Consolidated Health Care Plan (MCHCP) told the House Budget Committee that rising prescription use of GLP‑1 drugs for diabetes and weight‑loss purposes has been a major driver of pharmacy spending.

"In 2023, we spent roughly $26,000,000 on GLP‑1 drugs," MCHCP executive director John Wehman said. He said the number rose to $56.5 million in 2024 and to about $96.4 million most recently, contributing to a pharmacy spend that rose from $153 million to $218 million over the same period.

Wehman said the plan’s actuaries and board are adjusting benefit design and will put the pharmacy benefit manager contract out to bid this year, and that MCHCP is pursuing programs that combine medication with lifestyle coaching to try to moderate utilization. He emphasized the difficulty of removing drugs from formularies once they are in place for clinical indications such as diabetes, and said the board did not anticipate the rapid non‑diabetes demand for these products.

Committee members asked for a breakdown of GLP‑1 use by clinical indication (diabetes versus weight‑loss) and for utilization statistics. Wehman said MCHCP has about 11,000 members prescribed GLP‑1 drugs but did not provide a full split in the hearing; he said the plan is pursuing a PBM procurement and other utilization management strategies.