The semaglutide class of medications such as Ozempic, Wegovy, and Mounjaro have quickly become some of the most commonly prescribed medications in America. Ozempic and Mounjaro were initially designed to treat diabetic patients as they have been extremely effective in controlling glucose levels. However, they have also been extremely effective for weight loss. Thus, the same company that makes Ozempic developed Wegovy, the same semaglutide medication, but branded specifically for weight loss. Wegovy (semaglutide) was approved for chronic weight management in 2021.
These medications exploded in 2022 when Ozempic, Wegovy, and Mounjaro offered $25 coupon cards for patients to start the medication, however these cards have since expired for most patients requiring them to pay out of pocket, use insurance or a combination. These medications out of pocket are over $1,000 a month currently.
Insurance coverage of these medications is a complicated topic as it varies from insurance company to insurance company. Most commonly patients have to be a diagnosed type 2 diabetic to qualify for insurance coverage in most instances. However, even when covered by insurance that does not mean the medication is covered in full. Typically, some portion of the medication is covered, and patients are responsible for paying the remainder out of pocket.
Insurance has typically not covered Ozempic, Wegovy, or Mounjaro for chronic weight management. Thus, many patients have turned to a compound version of semaglutide as a more affordable option. The compound semaglutide has allowed patients that do not have insurance or their insurance does not cover the medications to be able to start the semaglutide treatments.
It will be interesting over the next couple years to watch the evolution of insurance in the world of chronic weight management. It has been shown repeatedly that helping patients live a healthier lifestyle will decrease the risk of developing diabetes, strokes and heart disease in the future. If you have had difficulty with insurance coverage of Ozempic, Wegovy, and Mounjaro please ask your provider if a compounded version of semaglutide would be an option for your weight loss journey. Reach out to our team to learn more about our weight loss program using the skinny shot.