Glucagon-like peptide-1 (GLP-1) agonists such as Ozempic and Wegovy were initially approved for treating type 2 diabetes but now have been indicated for other conditions including chronic weight management. This paper explores the recent growth in utilization and spending on these drugs within Medicaid fee-for-service and managed Medicaid. The paper also provides a framework for state Medicaid programs for benefit design decisions. The report discusses: 

• Some background on GLP-1s
• Recent growth and market demand
• Drivers of GLP-1 agonist utilization 
• Medicaid coverage of GLP-1 agonists for chronic weight management and type 2 diabetes
• A framework for ensuring appropriate utilization in Medicaid