Key Points
Dec 12 (Reuters) - Some patients with type 2 diabetes say they are having more difficulty getting reimbursed for drugs like Ozempic as U.S. insurers implement restrictions designed to deter doctors from prescribing the medication for weight loss.. confirmed in a recent email that it is seeing tighter health plan management of GLP-1 drugs including Ozempic and is working to minimize disruption for type 2 diabetes patients..
Out of 24 diabetes patients contacted by Reuters on Reddit, 13 reported recent problems getting their health plans to cover Ozempic or Mounjaro, a similar drug sold by Eli Lilly (LLY.N)...
"What's really resulted in kind of a more heightened focus on prior authorization for the diabetes GLP-1 drugs is the increased volume from off-label prescribing for weight loss," said Cory Midlam, director in Willis Towers Watson's pharmacy practice, which advise employers on benefits...
Some diabetes patients told Reuters that prior authorization, in which doctors need insurer permission before prescribing a medicine, had delayed by weeks, or even months, their ability to start a new medication or stay on a drug they had been taking..
A recent JP Morgan survey of U.S. benefits executives found that 74% of large employer-based health plans required diabetes patients to get prior authorization for a GLP-1, and a third of the rest planned to add the requirement as they grapple with higher spending on the medications as weight-loss tools...
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