Medicaid coverage of obesity medications limited; Death in the sickle cell experiment

Good morning everyone, and how are you today? We are fine, thank you very much, even if the sky over the Pharmalot campus is cloudy. After all, the birds are still chirping and a fresh autumn breeze is blowing by. Additionally, this is an exciting day on this side of the pond, where millions of voters are casting their ballots in hopes of changing their world. We can only imagine what lies ahead. To cope, we do what we do best: fire up the coffee kettle for another cup of stimulation. Our choice today is Jack Daniels, a necessary – and real – choice. Please feel free to come to us. In the meantime, here are some interesting things that may not only provide useful information but also a welcome distraction. I hope your day goes well. …

A patient with sickle cell disease died while participating in a clinical trial of a CRISPR-based treatment from Beam Therapeutics, threatening to overshadow early signs of effective gene editingSTAT reports. Beam said the patient succumbed to respiratory failure that was believed to be “probably caused by chemotherapy” that was needed to prepare the patient for BEAM-101, a treatment that uses the company’s new, more precise form of CRISPR gene editing called “Base Editing” is used. The patient who died was one of six participants with sickle cell anemia treated so far in Beam’s first clinical trial. The death occurred four months after the patient received BEAM-101, and the U.S. Food and Drug Administration, informed of the death, allowed Beam to continue the study without changes. The death underscores the risks of one-time genetic treatments for blood disorders such as sickle cell anemia and beta thalassemia. Gene editing has arrived in the 21st century, but it remains tied to a highly toxic chemotherapy called busulfan, which was approved in the 1950s.

Obesity drug coverage in Medicaid remains limited, with 13 state Medicaid programs covering GLP-1 for obesity treatment beginning in August 2024, it said a survey by the KFF. In total, a dozen states reported covering GLP-1 weight loss supplements under their fee-for-service Medicaid programs as of July 1, and North Carolina added coverage in August. All 12 states reporting coverage as of July 1 also reported using controls, most often prior authorization or body mass index requirements. Eleven of the 12 states reported coverage of all three GLP-1 drugs currently approved to treat obesity – Saxenda, Wegovy and Zepbound. Meanwhile, Medicaid prescriptions and gross GLP-1 spending have increased rapidly in recent years, nearly doubling from 2022 to 2023. Overall, the number of GLP-1 prescriptions increased by more than 400% from 2019 to 2023, while gross expenditures increased by over 500%. Spending per prescription before rebates reached more than $900 per prescription in 2023.