Insurance Coverage for Obesity Medications: Expert Insights and Requirements

Insurance companies are facing challenges in covering medications for obesity treatment due to the high costs. Drugs originally designed for diabetes management, such as semaglutide, have shown effectiveness in reducing body weight, leading to increased demand and supply shortages. Clinicians and patients report pushback from insurance companies, with some insurers prohibiting the use of weight loss medications altogether. The cost-effectiveness of these medications is a key concern for insurers, who often require prior authorization and may impose restrictions on coverage. Educating patients on insurance plan details and exploring all medication options are recommended strategies. Compounded weight loss drugs are available but lack FDA approval and quality control. Long-term cost-effectiveness data and addressing the stigma associated with obesity are needed to improve insurance coverage for obesity treatment.