![]() With the exception of Mounjaro, which was approved earlier this year, the versions of the drugs used to treat diabetes are covered by most insurance. Similarly, a higher dose of the drug liraglutide is sold under the name Saxenda for weight loss, and at a lower dose, it’s sold as Victoza, for diabetes.Semaglutide, when marketed for weight loss, is sold at a higher dose and called Wegovy at a lower dose, it’s marketed for diabetes and sold as Ozempic.Tirzepatide is sold under the name Mounjaro for diabetes.Are weight loss drugs covered by insurance?Īt lower doses, all three of the drugs are already approved to treat diabetes. ![]() In trials, Wegovy and Saxenda reduced body weight by around 15% and around 5%, respectively. Most patients in the trial had a body mass index, or BMI, of 30 or higher. However, Eli Lilly’s tirzepatide also imitates a second hormone, called GIP, which along with reducing appetite, may also improve how the body breaks down sugar and fat.Ī phase 3 clinical trial found a high dose of tirzepatide helped patients lose 22.5% of their body weight on average, or about 52 pounds, better than any medication currently on the market. All three drugs - which are given as injections - work in a similar way: They’re a class of drugs called GLP-1 agonists, which mimic a hormone that helps reduce food intake and appetite. ![]() The drugs have been shown in clinical trials to be highly effective for weight loss. David Rind, the chief medical officer for the Institute for Clinical and Economic Review, a research group that helps determine fair prices for drugs. If the FDA confirms the drug’s effectiveness, a “fair” price for tirzepatide could be around $13,000 annually, or around $1,100 a month, said Dr. Outside experts said it is possible the drugmaker could price it similarly to Wegovy, which carries a list price of around $1,500 for a month’s supply, and Saxenda, which costs about $1,350 for a month’s supply. Kelly Smith, a spokesperson for Eli Lilly, declined to comment on what tirzepatide will cost. ![]() Another Wall Street analyst, Colin Bristow at UBS, estimated the drug would reach $25 billion in annual sales - a figure that would still surpass the record $20.7 billion set by AbbVie’s rheumatoid arthritis drug Humira in 2021.
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