What state Medicaid programs paid for weight loss drugs

State Medicaid programs paid for at least 606,681 prescriptions of the three drugs licensed for weight management in 2026Q1, according to the federal payment file every state reports into. That is a payment record, not a coverage rule, and 960 of 2,894 reporting rows were withheld for being too small to publish.

By the Covered Weight editorial team · Updated Aug 3, 2026. Research and sourcing by Evan Reid.

The drugs licensed for weight management

These are the three the Food and Drug Administration licensed for chronic weight management. Each figure is the whole country for 2026Q1, taken from the dataset’s own national rows rather than added up from the states.

National paid claims for weight management drugs, 2026Q1
Drug	Paid prescriptions	How to read it	Rows withheld	Read from
Zepbound®tirzepatide	at least 366,283	At least one reporting cell was withheld for being too small to publish, so the true number is higher than this one.	187 of 5065 jurisdictions withheld entirely	State Drug Utilization Data 2026, Datastore query result, product_name like ZEPBOUND%, quarter 1, 2026, every jurisdiction Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 5, 2026 Read the line this comes from {"state": "XX", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "ZEPBOUND ", "suppression_used": "false", "number_of_prescriptions": "56994"} One row of the API response for the query in url, with the fields that do not bear on this fact omitted and the rest left exactly as the API returns them, including the trailing spaces the ten-character product_name field pads with. Open the url to re-read the whole result set and re-sum it.
Wegovy®semaglutide	at least 237,537	At least one reporting cell was withheld for being too small to publish, so the true number is higher than this one.	189 of 5152 jurisdictions withheld entirely	State Drug Utilization Data 2026, Datastore query result, product_name like WEGOVY%, quarter 1, 2026, every jurisdiction Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 5, 2026 Read the line this comes from {"state": "XX", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "WEGOVY 2.4", "suppression_used": "false", "number_of_prescriptions": "32316"} One row of the API response for the query in url, with the fields that do not bear on this fact omitted and the rest left exactly as the API returns them, including the trailing spaces the ten-character product_name field pads with. Open the url to re-read the whole result set and re-sum it.
Saxenda®liraglutide	2,861	Every matching reporting cell was published, so this is the number of paid prescriptions.	17 of 2813 jurisdictions withheld entirely	State Drug Utilization Data 2026, Datastore query result, product_name like SAXENDA%, quarter 1, 2026, every jurisdiction Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 5, 2026 Read the line this comes from {"state": "XX", "year": "2026", "quarter": "1", "utilization_type": "MCOU", "product_name": "SAXENDA ", "suppression_used": "false", "number_of_prescriptions": "2245"} One row of the API response for the query in url, with the fields that do not bear on this fact omitted and the rest left exactly as the API returns them, including the trailing spaces the ten-character product_name field pads with. Open the url to re-read the whole result set and re-sum it.

The same molecules, sold for diabetes

This is the comparison the headline number hides, and it is the reason a paid claim cannot answer a coverage question. One molecule carries different brands for different licences: tirzepatide (Zepbound®) for chronic weight management and tirzepatide (Mounjaro®) for type 2 diabetes, semaglutide (Wegovy®) for weight management and semaglutide (Ozempic®) for diabetes. The molecule is the same. The licence, the drug list and the prior authorization rules are not.

National paid claims for the diabetes-licensed brands, 2026Q1
Drug	Paid prescriptions	Rows withheld	Read from
Mounjaro®tirzepatide	at least 481,736	127 of 605	State Drug Utilization Data 2026, Datastore query result, product_name like MOUNJARO%, quarter 1, 2026, every jurisdiction Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 5, 2026 Read the line this comes from {"state": "XX", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "MOUNJARO 5", "suppression_used": "false", "number_of_prescriptions": "63065"} One row of the API response for the query in url, with the fields that do not bear on this fact omitted and the rest left exactly as the API returns them, including the trailing spaces the ten-character product_name field pads with. Open the url to re-read the whole result set and re-sum it.
Ozempic®semaglutide	at least 846,012	52 of 317	State Drug Utilization Data 2026, Datastore query result, product_name like OZEMPIC%, quarter 1, 2026, every jurisdiction Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 5, 2026 Read the line this comes from {"state": "XX", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "OZEMPIC 2M", "suppression_used": "false", "number_of_prescriptions": "167156"} One row of the API response for the query in url, with the fields that do not bear on this fact omitted and the rest left exactly as the API returns them, including the trailing spaces the ten-character product_name field pads with. Open the url to re-read the whole result set and re-sum it.
Rybelsus®semaglutide	45,697	66 of 238	State Drug Utilization Data 2026, Datastore query result, product_name like RYBELSUS%, quarter 1, 2026, every jurisdiction Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 5, 2026 Read the line this comes from {"state": "XX", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "RYBELSUS 1", "suppression_used": "false", "number_of_prescriptions": "11990"} One row of the API response for the query in url, with the fields that do not bear on this fact omitted and the rest left exactly as the API returns them, including the trailing spaces the ten-character product_name field pads with. Open the url to re-read the whole result set and re-sum it.
Victoza®liraglutide	12,742	36 of 125	State Drug Utilization Data 2026, Datastore query result, product_name like VICTOZA%, quarter 1, 2026, every jurisdiction Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 5, 2026 Read the line this comes from {"state": "XX", "year": "2026", "quarter": "1", "utilization_type": "FFSU", "product_name": "VICTOZA 6M", "suppression_used": "false", "number_of_prescriptions": "4264"} One row of the API response for the query in url, with the fields that do not bear on this fact omitted and the rest left exactly as the API returns them, including the trailing spaces the ten-character product_name field pads with. Open the url to re-read the whole result set and re-sum it.
liraglutide (generic)®liraglutide	at least 35,684	286 of 560	State Drug Utilization Data 2026, Datastore query result, product_name like LIRAGLUTID%, quarter 1, 2026, every jurisdiction Centers for Medicare & Medicaid Services · Federal agency publication · Effective Jul 10, 2026 · SDUD 2026 file, distribution 3bf6d0ed-f534-5dad-89da-29c7f99933be, CMS modified 2026-07-10 · Read Aug 5, 2026 Read the line this comes from {"state": "XX", "year": "2026", "quarter": "1", "utilization_type": "MCOU", "product_name": "Liraglutid", "suppression_used": "false", "number_of_prescriptions": "6135"} One row of the API response for the query in url, with the fields that do not bear on this fact omitted and the rest left exactly as the API returns them, including the trailing spaces the ten-character product_name field pads with. Open the url to re-read the whole result set and re-sum it.

A larger number next to a diabetes brand is not evidence that a program prefers it for weight loss. It is evidence that more people were treated for diabetes with it, which is what it is licensed for.

By state, for the jurisdictions published so far

Each state page carries every drug, every quarter on file, and what the program’s own drug list says where that is published. This table is the way in.

Paid claims for weight management drugs by state, 2026Q1
State	Zepbound®	Wegovy®	Saxenda®
California	No cell	No cell	No cell
New York	No cell	No cell	No cell
Ohio	No cell	No cell	No cell
Texas	No cell	No cell	No cell

4 jurisdictions are published so far. A state joins this table in the same change that publishes its pages, so a row here always means its record has been through the same review as everything else on the site.

What this can and cannot tell you

This snapshot counts prescriptions state Medicaid programs paid for in one quarter, as reported to the federal government. It is not a ranking of which programs cover a drug. A low count can mean a small reporting cell that was withheld, a program where most enrollees are in managed care, or a rule that few people clear. A hidden cell and a missing cell each carry their own typed value here, and neither is rounded to zero.

States report late and CMS restates the file, so the most recent quarter here is the one most likely to move. Every page rendering it says which quarter it is and when it was read.

If you want the answer for your own case, the question to settle first is which program and which plan you are in, and then what that program’s drug list and prior authorization criteria require. That is a different question from this one. If a request has already been denied, the appeal route has its own page.

Start by finding out which document governs your plan

Everything else follows from it. A state program publishes its own rules. A marketplace plan is measured against a state benchmark. An employer plan that pays claims out of the employer's own funds sets its own rules, and no state rule reaches it.

Answer six questions

Common questions

Does a paid claim mean Medicaid covers the drug for weight loss?

No. A paid claim shows a prescription was filled and paid for. It does not say which condition it was prescribed for, and the same molecule is often paid for diabetes while being excluded for obesity. The program drug list and its prior authorization criteria decide the rule, not this number.

Why does a number say "at least"?

Because at least one reporting cell was withheld for being too small to publish. When that happens the published figure is a floor rather than a total, so the true number is higher. The wording is part of the value here rather than a footnote, because a floor printed as a count is a false number.

A state shows no number. Does that mean the program pays for nothing?

No, and this is the most common way this dataset gets misread. A withheld cell is not a zero and an absent row is not a no. It can mean a reporting cell too small to publish, a program where most enrollees are in managed care, or simply that the federal file carries no row for that product in that quarter.

Why are only some states listed by name?

Because a row here means that jurisdiction has been through the full review this site applies before publishing anything about it. Data exists for all fifty-one, and a row appears in the same change that publishes that jurisdiction pages. The national total below covers the whole country either way.