Insurers cracking down on Ozempic prescriptions

Insurers cracking down on Ozempic

If you think you're going to easily get a prescription for Ozempic or Wegovy and have your insurance automatically cover it, think again, as it seems some insurers are going through every prescription with a fine-toothed comb to ensure users really need the drug.

The weight-loss drug Ozempic has been in the headlines for months now, with story after story of how it has led to dramatic weight loss in everyone from celebrities like Oprah Winfrey, Elon Musk, and Amy Schumer to regular, everyday patients.

The skyrocketing demand for the drug has even created a shortage, and now, some insurance companies are warning doctors against over-prescribing the expensive weight-loss drug.

"The drug should really only be prescribed for type two diabetics and of course, there's a national shortage so when physicians are seeing patients who are just overweight and maybe insulin resistant and maybe pre-diabetic and saying that they need this drug for diabetes that's actually fraudulent. The insurance companies do have the right to kick back." said weight loss specialist Dr. Sue Decotiis.

A spokesperson for America's Health Insurance Plans, a trade group representing insurance companies said in a statement: "Health insurance providers will continue to review the clinical evidence and conditions for which a medication is approved to support safe and effective treatments for patients."

"I think the real issue is that obesity treatment is not a standard benefit on insurance policies," said Dr. Angela Fitch, President of the Obesity Medicine Association. "The biggest thing that we can do as a country right now is to make sure that anyone who has the disease of obesity has access to effective treatment."

Dr. Fitch said the thing she'd like to see is a day when all insurance companies cover all kinds of treatment for obesity.

"For so long people have thought that obesity is just their fault and it's not their fault. It's a disease like any other disease that oftentimes needs to have medication, treatment, and surgery in order to treat it effectively," Dr. Fitch said.