If you’re aiming for a healthier weight, you might consider semaglutide drugs such as Ozempic or Wigovy. Semaglutide mimics a hormone called glucagon-like peptide-1 (GLP-1). regulation of appetite and blood sugar control. However, these drugs are expensive and intended for long-term use, so cost can be a major concern. So how much does Ozempic cost? Is it covered by insurance? Here’s what you need to know and some simple tricks to lower your out-of-pocket costs.
How much does Ozempic cost?
Taking GLP-1 receptor agonists can cause rapid weight loss. In fact, in one study, diabetes, obesity, metabolism They found that participants who took 2.4 mg of semaglutide for 68 weeks lost up to 20 percent of their body weight. (For a person weighing 160 pounds, that’s about 30 pounds in 16 months.)
To achieve these weight loss results, semaglutide must be taken regularly. And it can be expensive. So how much does Ozempic cost exactly? If you’re paying out of pocket. list price The price for 4 weeks of Ozempic is $968.52. of list price A four-week supply of Wegovy costs $1,349.02.
Have you considered taking Ozempic for weight loss?
Needless to say, these numbers are mind-boggling, especially considering that the study results above were based on 68 weeks of treatment. Total costs over 68 weeks can be more than $16,000 for Ozempic and nearly $23,000 for Wegovy.
“These drugs are expensive,” he says Sranya Misra, Maryland, BCMASfounding physician of Mithra Wellness. “Cost is definitely a barrier to patients receiving treatment.” The good news? Discounts are available and insurance may cover the cost of Ozempic and other semaglutide drugs, so most people do not need to pay the full list price.
Is Ozempic covered by insurance? Three important factors
Both Ozempic and Wegovy may be covered by insurance, but the amount covered will vary depending on your health insurance plan and medical needs. Here are some factors that may affect whether your insurance will pay for your Ozempic or Wegovy prescription.
Types of insurance plans
According to a study published in American Medical Association Health Forum Journalthe majority of prescriptions for Ozempic and Wegovy are covered by commercial insurance. Ozempic may also be covered by Medicare Part D and Medicaid. However, it may be difficult to apply Wegovy in these programs as weight loss drugs are prohibited (see below for details).
Use of “on-label” and “off-label”
Ozempic and Wegovy both contain the same active ingredient (semaglutide). But Ozempic FDA approved Treats type 2 diabetes by improving blood sugar control and reducing the risk of cardiovascular disease. Wegovy, on the other hand, FDA approved For weight management.
Some doctors may prescribe Ozempic “off-label” to help you lose weight. In other words, you will be prescribing it to someone. without it Type 2 diabetics who want the side effect of weight loss. But many insurance companies are cracking down and refusing to cover off-label prescriptions for Ozempic, Misra said.
medical necessity
To qualify for insurance plan coverage, you must prove that the drug is necessary to maintain or improve your health. Without a diagnosis, type 2 diabetesDr. Misra says insurance typically doesn’t cover Ozempic.
For Wegovy, the medical criteria are either a BMI of 30 or higher; BMI 27 or more At least one obesity-related comorbidity (such as high blood pressure, type 2 diabetes, or abnormal cholesterol levels). (You can calculate your BMI, or body mass index. here. )
“We also use abdominal waist circumference as a tool because visceral fat is correlated with increased cardiovascular disease,” says Dr. Misra. “Women with a waist circumference of 35 inches or more and men with a waist circumference of 40 inches or more may be candidates for treatment.”
In some cases, Wegovy may be prescribed. Treat polycystic ovary syndrome (PCOS). Women with PCOS may develop insulin resistance or experience weight gain, which can be alleviated with the drug semaglutide. However, many insurance plans still do not cover weight loss drugs. And in your case, you may need to get special approval to cover your prescription of semaglutide for PCOS.
How to save on Ozempic if you don’t have insurance
You can check whether your insurance plan usually covers semaglutide Fill out a short survey on the manufacturer’s website here Ozempic and here wegobee). Even if you lack coverage, there are several options to reduce costs. Here are some things that may help:
Check out patient assistance programs
Discounts are available directly from the Ozempic manufacturer. of Novo Nordisk Patient Assistance Program Medicines (Ozempic and Libersusoral semaglutide), will be provided free of charge to those who meet certain eligibility criteria.
Eligibility criteria include having Medicare or being uninsured and having a household income at or below 400% of the federal poverty level. To check the amount depending on the number of family members, please visit the following site. Needy Meds.
If you don’t meet that criteria, you may still be able to request a sample from your doctor, but supply shortages often limit what samples are available.
Apply for Ozempic Savings Card
Not eligible for free Ozempic or your insurance plan doesn’t fully cover the cost? Find out if you’re eligible ozempic savings card. This is available to people with private or commercial insurance (such as through an employer) who have a 1, 2, or 3 month supply of Ozempic prescriptions.
Those who qualify for this program can get Ozempic for just $25 per month. However, there are limits. Discounts are capped at $150 for a 1-month prescription, $300 for a 2-month prescription, and $450 for a 3-month prescription. The exact savings will depend on your specific insurance plan’s coverage.
Even if you don’t qualify for an Ozempic Savings Card, you may still be able to save money with prescription discount cards such as: Good R, single care or RxSaver. These can help both insured and uninsured people reduce the cost of medications such as Ozempic and Wigovy. Check our website to compare prices and discounts at pharmacies near you.
Consider installing a dispensing pharmacy
The drug semaglutide may also be available. dispensing pharmacythis is a type of pharmacy that mixes ingredients to create custom medicines. Compounding pharmacies make semaglutide more affordable and accessible to patients concerned about supply shortages and lack of insurance coverage.
“Provision and continuity of treatment are key factors in determining treatment options,” says Dr. Misra. “Some physicians feel strongly that at least compounding is generally an affordable option and one that reduces anxiety about treatment.”
But she cautions that the FDA does not approve drugs made by compounding pharmacies. Ask your doctor for recommendations and make sure the pharmacy is licensed. Pharmacy Dispensing Certification Committee. Search for PCAB-certified dispensing pharmacies in your area. here. Select “PCAB Pharmacy” as the program and narrow down your location.
This content is not intended to be a substitute for professional medical advice or diagnosis. Always consult your doctor before proceeding with any treatment plan.
