BALTIMORE — Maryland is moving to limit how much the diabetes and weight loss drug Ozempic costs, starting with government employees before expanding statewide.
The state's Prescription Drug Affordability Board approved an upper payment limit on the drug of $274 for a 30-day-supply. The drug can cost over $1,000 a month without insurance.
The cap currently applies to government employee health plans, but will go into effect statewide in 2028.
Maryland is capping Ozempic costs for state employees now, everyone in 2028
The rising popularity of Ozempic and other GLP-1 drugs used for weight loss has driven up costs significantly. Some school districts were forced to remove the drugs from their insurance plans entirely to manage expenses.
Ben Schmitt of the Howard County Education Association said the financial pressure was substantial.
"We were looking at, just based on GLP-1 medications, a $10 million increase in healthcare premiums for next year," said Schmitt.
Catherine Kirk Robins of Healthcare for All said the upper payment limit will deliver meaningful savings for government entities.
"The upper payment limit will put a limit on what these plans pay, and we estimate, or the board estimates that these government entities will save $5.8 million a year," said Kirk Robins
The larger impact will come when the limit expands beyond government employees.
"The state will see savings on Ozempics that we estimate to be around $164 million a year. So that will mean a lot for patients, for our insurance premiums, and for our taxpayer dollars," Kirk Robins said.
Schmitt said the cap could also restore access to the drug for members who lost coverage.
"So hopefully with this, this will kick in the ability to negotiate better pricing. It certainly has a cap and hopefully the returns will be we can get these back for usage by our members," said Schmitt.
Ozempic is the second drug the board has set a limit on. It is unclear which drug the board will target next, but Marylanders can provide input on which drugs are costing them the most and should be capped.
"So that is the place where we'd really like to get patients involved so that under all of those umbrellas of, of targets, they can really prioritize ones that are impacting Marylanders the most," Kirk Robins said.
Marylanders can contact the Prescription Drug Affordability Board to weigh in on which drugs should be prioritized for future caps here.
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