In 2023, the FDA will likely approve Eli Lilly's diabetes drug tirzepatide for weight loss — but there's little indication insurers will widely cover the medication.
At lower doses, all three of the drugs are already approved to treat diabetes.Semaglutide, when marketed for weight loss, is sold at a higher dose and called Wegovy; at a lower dose, it’s marketed for diabetes and sold as Ozempic.
That belief — in addition to older anti-obesity medications not being very effective — has made insurers reluctant to cover many of the new therapies, he said. What’s more, Butsch said, not everyone responds the same way to any given weight loss drug. If the drug covered by insurance isn’t effective for that patient, there are usually no other drug options left, he said.
Dr. Fatima Stanford, an obesity medicine specialist and the equity director of the endocrine division at Massachusetts General Hospital in Boston, said that private insurance coverage for anti-obesity medications is spotty, with treatments often restricted to the most expensive plans.