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Evidence-based GLP-1 & peptide discussion since 2023
ForumsInternationalCanadian GLP-1 coverage — 12 month update Page 3

Canadian GLP-1 coverage — 12 month update

Dr.SleepRoch Tue, Dec 17, 2024 at 4:46 AM 52 replies 2,746 viewsPage 3 of 11
JessicaH_TX
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Dec 18, 2024 at 5:52 PM#11
anders_CPH said:
Telehealth prescriber review for cost and coverage: I've used 2 different telehealth platforms to get my GLP-1 prescription.

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

Last edited: Dec 18, 2024 at 9:52 PM
34 7wendy_avl, jason_paloalto, Dr.LeslieOBGYN and 31 others
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fiona_glasgow
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Glasgow, UK
Dec 18, 2024 at 8:21 PM#12
TomFromTexas said:
Financial impact of cost and coverage weight loss beyond medication cost: Groceries: SAVED $281/month (eating less) Restaurants: SAVED $211/month…

Thank you — that is the clearest version of this I have read, and I have read a lot of them. Printing the relevant bit and taking it with me.

35 8TirzTom, TrialTracker_MD, JennaRN and 32 others
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PharmacoVig_BOS
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Feb 2024
Boston, MA
Dec 18, 2024 at 10:50 PM#13
anders_CPH said:
Telehealth prescriber review for cost and coverage: I've used 2 different telehealth platforms to get my GLP-1 prescription.

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 ($137/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.

36 9DataDave, Dr.GutHealth, amsterdam_pete and 33 others
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BethLabQueen
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May 2024
Virginia
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Dec 19, 2024 at 1:19 AM#14
Dr.SleepRoch 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…
Dr.SleepRoch said:
...compounded vs brand cost and coverage...

This debate comes up weekly and I think both sides have valid points:

Pro-brand: FDA-approved, manufacturing standards guaranteed, clinical trial data directly applicable

Pro-compounded: 10x cost savings, same active molecule, independent testing available, accessibility

My position: if you can afford brand or have insurance coverage, that's the gold standard. If not, properly tested compounded from a 503B pharmacy is a reasonable alternative. Neither side should shame the other.

37 10cory_ATX, lori_vegas, Dr.PulmRoch and 34 others
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Admin
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Dec 19, 2024 at 3:48 AM#15

Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source.

Last edited: Dec 19, 2024 at 7:48 AM
38 11PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 35 others
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