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MHE Question of the Week: Health Insurance Coverage of GLP-1s for Weight Loss

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Please pick the statement that most closely resembles your view of health insurance coverage of GLP-1s for weight loss.

The glucagon-like peptide 1 (GLP-1) drugs is a class that includes now-famous Ozempic (semaglutide) and Mounjaro (tirzepatide), which were approved by the FDA as diabetes treatments but have been used off-label for weight loss. After FDA approvals, on-label versions are available for weight, marketed under the names Wegovy (semaglutide) and Zepbound (tirzepatide). Prescriptions of the GLP-1s have soared as patients and prescribers have flocked to a pharmaceutical answer to the U.S. obesity epidemic. The cost has strained insurer budgets. There are also questions about the long-term outcomes of GLP-1s and how long people are sticking with the treatments, which are administered as injections.

Please pick the statement that most closely resembles your view of health insurance coverage of GLP-1s for weight loss.

Please pick the statement that most closely resembles your view of health insurance coverage of GLP-1s for weight loss

Insurers should work to limit prescriptions with prior authorization, utilization management and other managed care strategies because the long-term results of the GLP-1s for weight loss are uncertain.
Insurers should cover GLP-1s because so many people have obesity, and obesity is major risk factor for many chronic healthcare conditions.
Insurers should require participation in a weight-loss program as a precondition for coverage of GLP-1s.
Medicare should start covering weight-loss drugs, including GLP-s, partly because doing so would encourage coverage by private insurers.

We want to know what you’re thinking! Every Monday morning the editors of Managed Healthcare Executive are posing a question to our readers about a timely issue in U.S. healthcare. Answers will be published every Friday.

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