JenPlateau said:

Dr.GastroMayo said: ...regarding the discontinuation data for cost and coverage...

Financial impact of cost and coverage weight loss beyond medication cost:

• Groceries: SAVED $289/month (eating less)
• Restaurants: SAVED $159/month (fewer meals out)
• Alcohol: SAVED $109/month (stopped drinking)
• Life insurance: Premium REDUCED by $39/month (lower BMI)
• Copays: SAVED $59/month (fewer BP/cholesterol meds)

Net impact after medication cost: approximately BREAKING EVEN. The medication pays for itself through reduced food spending and healthcare costs. This surprised me.

Dr.ObesityLA said:

Dr.ReproEndo said: ...my insurance denied cost and coverage coverage because...

That reframing is the part I needed. Printing the relevant bit and taking it with me.

JenPlateau said:

Dr.GastroMayo 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 1 attempts.

What finally worked: a letter from my endocrinologist documenting BMI history (>3 years), failed diet attempts, comorbidities (PCOS + insulin resistance), 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.

PharmD_Rodriguez said:

The list price and the price I actually pay differ by a factor of six depending on which of four routes I use, and none of that is transparent from…

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

Moderator note: the sourcing question belongs in the vendor section and has been split out. Tagging this one for the weekly digest.