West Virginia ends state employee GLP-1 obesity pilot, citing $1.3 million monthly cost

West Virginia's Public Employees Insurance Agency ended a pilot program that covered GLP-1 medications for obesity for about 1,000 state employees, citing a cost of roughly $1.3 million a month even after manufacturer rebates ^[1][2]. The agency paused the program on March 15, 2024, and the state honored existing pre-authorizations through June 30 or the end of their authorization term, whichever came later ^[1].

West Virginia Public Broadcasting's headline said the program was "ended," while its article and a later policy summary both described the March action as a pause or cancellation ^[1][2].

The pilot began in 2019 to help members with the cost of GLP-1 drugs, which are used to treat Type 2 diabetes and obesity ^[1][2]. PEIA provides health coverage for more than 230,000 public employees and retirees ^[1].

Cost drove the decision. PEIA director Brian Cunningham told the New York Times in June 2024 that the pilot cost around $1.3 million a month despite manufacturer rebates for a little more than 1,000 patients ^[1][2]. Sen. Tom Takubo, a Kanawha County Republican who chairs the Joint Standing Committee on Insurance and PEIA, said spending on the medications for PEIA "had quickly climbed to about $90 million" ^[1]. The article does not say over what period that $90 million was spent. For comparison, the list price for Ozempic — set by the manufacturer before insurance or discounts — is $968.52 per month, taken as one weekly dose ^[1].

State officials told MetroNews in August 2024 that the reasons for halting the program were "multifaceted," including cost, supply shortages, potential side effects and inconclusive results ^[1].

Supporters of the pilot point to results. Laura Davisson, director of medical weight management at West Virginia University, said returning pilot patients she has seen showed a 15.4 percent decrease in their body mass index ^[1]. "Not every single patient is a candidate for surgical treatment, and now we have these medicines that are out there that are fantastic," Davisson said ^[1]. Cassie Maxwell, a mother from Morgantown, said she lost almost 150 pounds on a GLP-1 prescription and that her pre-diabetic numbers, high blood pressure, cholesterol and sleep apnea all improved. She learned she was in the pilot when it ended ^[1].

Two bills aimed at restoring coverage failed. Del. Kayla Young's House Bill 4979, introduced during the 2024 regular session, never moved past the House Committee on Banking and Insurance ^[1]. Del. John Williams' House Bill 116, introduced in a May 2024 special session, never made it past the House Finance Committee ^[1]. Takubo said he and colleagues are working "creatively behind the scenes" with drugmakers and that qualifying criteria still need to be developed ^[1].

Why it matters for patients

State employee health plans and Medicaid programs are where many of the country's coverage decisions about GLP-1s are being made. As of March 2025, 11 states covered GLP-1s for weight loss under their state employee health plan, nine covered them under Medicaid, and five covered them under both ^[2].

West Virginia is one of several states that reversed course. Colorado announced in January 2025 that it would end GLP-1 coverage for obesity in its state employee plan starting July 1, 2025, expecting to save $17 million a year ^[2]. North Carolina pulled back its weight-loss coverage effective April 1, 2024, after utilization rose 731 percent to more than 23,000 members; its board estimated 2024 costs would exceed $170 million and top $1 billion over six years ^[2]. Illinois went the other way, adopting 2024 legislation requiring coverage of certain weight loss and obesity medications in its state employee plan ^[2].

For members, the practical effect is that coverage can change at a plan year or board decision even when a prescription is working. PEIA let existing authorizations run through June 30, 2024, or the end of their term, whichever was longer ^[1]. What happened to those patients' treatment after that point has not been reported.

What happens next

Colorado's coverage change takes effect July 1, 2025 ^[2]. In 2025, Arkansas, California, Maryland, New Mexico, Pennsylvania and Texas introduced bills to mandate GLP-1 coverage, but none are expected to gain traction this year ^[2]. Whether PEIA restores its obesity pilot, and under what criteria, has not been disclosed ^[1].