Under the terms of the demonstration, pharmaceutical manufacturers, including Indiana’s own Eli Lilly and Company and Novo Nordisk, will make select GLP-1 medications available to Indiana’s Medicaid program for $245 per member per month. After accounting for the Federal government’s contribution, Indiana will pay just $85.16 per person per month. The agreement increases access to obesity treatment for eligible Medicaid beneficiaries, providing Hoosiers and their healthcare providers with effective treatment options while giving the state a predictable pricing structure. Manufacturers will also provide a lifestyle support program at no additional cost to the state.
“Indiana is proud to expand access to essential treatment for eligible Hoosiers. This agreement reflects our commitment to Make Indiana Healthy Again by pursuing practical solutions that increase healthier lives,” said Governor Mike Braun.
“Obesity is a serious, chronic disease, and addressing it can open the door to better health,” said David A. Ricks, Chair and CEO of Eli Lilly and Company. “Here in Indiana, 71% of adults are living with obesity or overweight. This toll on our state’s health is also a toll on our economy, costing an estimated $10.7 billion a year, or nearly 2% of state GDP. Indiana opting into the BALANCE model is a meaningful step forward, and we’re grateful for the Governor’s leadership in making breakthrough medicines like Foundayo and Zepbound available to eligible Medicaid patients. We’re proud our home state is taking action to expand access to obesity treatment, so more Hoosiers can get the care they need.”
“At Novo Nordisk, we remain committed to improving access to innovative, FDA-approved medicines like Wegovy (pen and pill) for people living with obesity and other serious chronic diseases. We applaud Governor Braun and the State of Indiana for taking an important step to reduce barriers to obesity care and recognize CMS’s leadership in advancing the BALANCE model. We are encouraged by this decision, and we look forward to working with policymakers, healthcare professionals and other stakeholders to help more Americans achieve better health outcomes,” said Jamey Millar, Executive Vice President of U.S. Operations of Novo Nordisk.
Increasing access to obesity treatment has the potential to help more Hoosiers remain in the workforce, return to work and reduce reliance on public assistance programs. Additional implementation details, including eligibility criteria and timing, will be announced as the agreement is finalized.