Weight Loss Medications: How to get them and are they covered by insurance?

Trying to get your hands on weight loss medications may be harder than you think.

Weight loss medications: key differences.

Our previous article Semaglutide: science and side effects briefly touched on the differences between Ozempic®, Wegovy®, and Semaglutide. Here’s what you need to know:

• Novo Nordisk is a Danish pharmaceutical manufacturer and the makers of Ozempic® and Wegovy®.
• Ozempic® is FDA-approved for the treatment of type 2 diabetes.
• Wegovy® is FDA-approved for weight management.
• Semaglutide is the generic compounded form of both Ozempic® and Wegovy®.
• Each of these medications is a GLP-1 antagonist.

Variations of the same medication.

GLP-1 is a 30-amino acid peptide hormone that is naturally produced by the body. Its main purpose is to regulate our body’s insulin production but it also reduces hunger signals. Despite having different FDA approval indications, Ozempic®, Wegovy®, and Semaglutide are all synthetic GLP-1s and have the same mechanism of action. This means that all three medications help manage blood sugar and weight. The only significant difference between the medications is how they are dosed. Always follow your healthcare practitioner’s instructions regarding dosage and frequency for the best possible results.

All GLP-1 medications help manage blood sugar levels and weight.

How do I get a weight loss medication?

All GLP-1s are obtained by prescription only. Any medical provider with prescriptive authority can prescribe weight loss medications after obtaining bloodwork. However, depending on where you go, the medication you are prescribed might not be your decision. For example, primary care physicians rarely prescribe generic compounded medications. So, if you go to your doctor, you’ll most likely receive a prescription for Wegovy® for weight loss, or Ozempic® for “off-label” use. If you go to a weight loss specialist or clinic, you might have more options.

Specialty clinics can offer more choices in weight loss medications than primary care physicians.

I have a prescription, now what?

Unlike most other prescriptions, getting your weight loss medication is not as easy as walking up to your local pharmacy. The demand for Ozempic® and Wegovy® has outpaced supply for over a year. Novo Nordisk acknowledges the shortage, but with production already operating at capacity, have said they would, “continue to restrict supply in the U.S. to safeguard supply for existing patients.” Right now, U.S. pharmacies have about a 90-day waiting period before they can fulfill new Ozempic® and Wegovy® prescriptions. On the other hand, Semaglutide can be obtained much quicker. Semaglutide is compounded and patient-specific, so you still won’t walk out of the office on the same day as your initial consultation. Although, patients usually receive Semaglutide within one to two weeks after the medication is ordered.

You can expect to wait 90 days to get Ozempic® and Wegovy® or just one week for Semaglutide.

Are weight loss medications covered by insurance?

Weight loss medications are rarely covered by insurance and only if certain conditions are met. The most commonly covered is Ozempic® but you’ll need to be diagnosed a true diabetic before insurance will pay for the medication, being “pre-diabetic”, does not count. Outside of having diabetes, Wegovy® is sometimes covered, but only under extreme circumstances. If Wegovy® is covered, patients are likely to need a BMI of 27 or higher with at least one weight-related medical condition to meet requirements. Even if you are one of the lucky few to have weight loss medications covered by your insurance, many are finding out that their coverage stopped after the first month. Finally, there’s Semaglutide, which is not covered by insurance because it is a generic compounded medication. Since most patients will be paying for their weight loss medication out of pocket, here are the latest prices for a single month:

Ozempic : $889.30-945.32

Wegovy : $1280-1346

Semaglutide : $300-400

Let’s Recap:

• Ozempic®, Wegovy®, and Semaglutide are GLP-1 medications that help manage blood sugar levels and weight loss.
• GLP-1s are obtained by prescription from a doctor’s office or specialty clinic.
• Specialty clinics have more options for medication choice.
• There is a 90-day wait to fill a new Ozempic® or Wegovy® prescription, but only an average 1-week wait for Semaglutide.
• Plan on paying for your weight loss medication out-of-pocket. Cost per month for Ozempic® averages $900, or $1,300 for Wegovy®, but only $300 for Semaglutide.