LibrarianMeg said:

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

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

• Groceries: SAVED $292/month (eating less)
• Restaurants: SAVED $162/month (fewer meals out)
• Alcohol: SAVED $112/month (stopped drinking)
• Life insurance: Premium REDUCED by $42/month (lower BMI)
• Copays: SAVED $52/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.

nick_SD_fit said:

Insurance update relevant to cost and coverage: I just got my prior auth approved through Cigna after 1 attempts.

This is exactly what I could not find anywhere else. I will report back once I have actually tried it.

LibrarianMeg said:

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

LibrarianMeg said:

...regarding the discontinuation data for cost and coverage...

I want to reframe the discontinuation narrative. We don't say "insulin fails because blood sugar rises when you stop it." We don't say "antihypertensives fail because BP goes up without them."

Why do we apply different logic to anti-obesity medications? The answer is stigma. We still, unconsciously, believe obesity is about willpower rather than biology. The discontinuation data actually PROVES it's a chronic biological condition requiring ongoing treatment.

This reframing isn't semantic — it has implications for insurance coverage, treatment duration, and patient expectations.

lisa_labSD 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: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Report rather than reply if it drifts again.