US EditionMajor Insurance Changes Are Coming for Weight Loss Drugs. Here’s How It Could Affect Patients
- Beginning Tuesday, CVS Caremark will no longer cover Eli Lilly’s Zepbound, a GLP-1 medication approved by the FDA in late 2023 for helping adults with obesity or excess weight manage their weight over the long term.
- This decision follows prior authorization requirements and insurance coverage changes like BCBS Massachusetts excluding all GLP-1s for obesity except when treating type 2 diabetes, reflecting rising concerns about drug costs and coverage uniformity.
- Eli Lilly remains confident in Zepbound's effectiveness and has expanded access through LillyDirect, which offers monthly single-dose vials for $499 starting July 7, while patients and doctors express frustration about coverage disruptions and the complex trial-and-error needed to find effective treatment plans.
- Recent data shows roughly 63% of patients stay on GLP-1 treatments at least one year, but about 60% do not remain long enough for meaningful weight loss, with affordability and insurance coverage strongly influencing adherence, according to health experts and studies.
- These insurance changes underscore challenges in treating obesity as a chronic disease amid high drug costs and stigma, suggesting policymakers may need to reconsider coverage strategies to support patient access and long-term treatment success.
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Staying the Course: New Data Shows Surging Persistence in Weight-Loss Drug Usage
Recent analysis of U.S. pharmacy claims reveals nearly two-thirds of patients who began weight-loss drugs Wegovy or Zepbound last year continued usage for a full year, up from previous years. Improved insurance coverage and better side effect management are key factors, although long-term persistence remains challenging.
·India
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Major insurance changes are coming to GLP-1 drugs for weight loss. Here’s how that could affect patients
Starting July 1, CVS Caremark will stop covering Eli Lilly’s Zepbound. Wegovy, the GLP-1 medication to treat obesity from Lilly competitor Novo Nordisk, will still be covered under plans managed by CVS Caremark.
·Atlanta, United States
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