GenomicsKate said:

RetaRick_CA said: ...regarding the discontinuation data for cost and coverage...

Insurance update relevant to cost and coverage: I just got my prior auth approved through Cigna after 3 attempts.

What finally worked: a letter from my endocrinologist documenting BMI history (>3 years), failed diet attempts, comorbidities (sleep apnea + prediabetes), and referencing the STEP trial data.

If your PA keeps getting denied, don't give up. Request a peer-to-peer review between your doctor and the insurance medical director. That's what finally broke through for me.

JessicaM_2024 said:

Financial impact of cost and coverage weight loss beyond medication cost: Groceries: SAVED $214/month (eating less) Restaurants: SAVED $164/month…

This answered a question I did not know how to ask. Printing the relevant bit and taking it with me.

GenomicsKate said:

RetaRick_CA said: ...regarding the discontinuation data for cost and coverage...

My insurance denied my PA related to cost and coverage. Has anyone successfully appealed? I'm considering going compounded instead.

ZaraB_AL said:

Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the…

Insurance coverage hack for cost and coverage: if your insurance denies brand Wegovy/Ozempic, consider these alternatives:

1. Prior authorization appeal with peer-to-peer review
2. Manufacturer copay card (for commercial insurance)
3. Patient assistance programs (Novo Nordisk, Eli Lilly)
4. Compounded medication from a 503B pharmacy ($139/month)
5. Canadian pharmacy (requires prescription, ~40-60% savings)

Don't let cost prevent access to effective treatment. There are options at every price point.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Report rather than reply if it drifts again.