Least expensive semiglutide?

July 31, 2024 2:31 PM

I'm looking for the least expensive semiglutide...

I do not have diabetes; it's just for weight loss. I think my dr will rx any of the meds except ozempic (which is a little confusing?)

I have Aetna. I looked into a couple of savings cards but got nowhere.

Any ideas on the cheapest way to get any of these semiglutides? I'm open to an online dr visit to do so.

Also, please answer the question as asked, and I know about the health risks and the need to stay on the meds possibly forever, etc.

posted by bookworm4125 to Health & Fitness (6 answers total)

Mochi, Henrymeds, Noom and even Weight Watchers have telemedicine practices that will prescribe compounded semaglutide. The brand name version of semaglutide for weight loss is Wegovy; Zepbound and Mounjaro are the weight loss/T2D versions of tirzapatide, another GLP-1.

All the brand names cost, retail, between 900-$1300/mo; many of them have savings cards that will bring the cost down 50% for people with commercial, non-government insurance.

Your specific insurance plan, from your specific employer (not just the company like Aetna) will determine whether you can get coverage. I can and pay $25/month, but I know I'm insanely lucky in this respect. It still required a prior authorization from my doctor. My GP's PA request wasn't accepted and I had to see a bariatric nurse practitioner at the local hospital system, who knew how to write it in a way that would get it covered.

Compounded GLP-1s are going to be cheaper, but are perceived as riskier because the Big Pharma quality control process isn't in place. Also, the packaging (like, the injection pen itself) may not be as nice although I've never heard that they aren't sufficient. You'll have to price the compounded medication out -- I've seen prices from $250-500/month. Some doctors will prescribe compounded meds and some won't. Insurance doesn't cover it.

Each med has a related subreddit that can be helpful for learning what telemedicine practices are popular.

That's sort of a brain dump but I hope it helps.
posted by chesty_a_arthur at 3:19 PM on July 31 [4 favorites]

1) Sign up for the manufacturer's prescription card for the medication your doctor is willing to prescribe for you, or both:

Wegovy: https://www.novocare.com/obesity/products/wegovy/savings-offer.html
Zepbound: https://zepbound.lilly.com/coverage-savings

2) Call your pharmacy and have them put the savings card codes on your account
3) Have your doctor write the prescription and send it to your pharmacy
4) Your pharmacy will submit it to insurance
5) In almost all cases, your insurance will send a request for pre-approval to your doctor
6) If your doctor does not submit a pre-approval to insurance within a week, get in touch with the doctor to ask them to do so
7) Your insurer will approve or deny the prescription
8) Once your insurer makes a determination, the pharmacy will tell you the final cost with both insurance and savings card when it is ready for pickup

The savings cards can vary tremendously based on the specifics of your insurance plan's coverage. Your pharmacy will not be upset if you choose not to pick up the prescription if it is particularly expensive, someone else will take it.

I would not recommend pursuing the route of purchasing compounded semaglutide or tirzepatide at a compounding pharmacy before going through the above process to check what the costs will be via the standard channels. The manufacturer's product through a local pharmacy with insurance and a manufacturer's savings card can be lower in price (and in my case has been) than the medication through a compounding mail order pharmacy.
posted by I EAT TAPAS at 3:24 PM on July 31 [2 favorites]

Check with your pharmacy benefit manager (PBM), which is the middleman that sits between your insurance and your pharmacy and sets your cost. For example, my insurance is with Cigna; the PBM for Cigna is CareMark. Logged into the CareMark website, which has the exact details of my exact plan, I can enter the name of any medication and learn the out of pocket cost and whether a prior authorization is required. It matters far less who your prescriber is (your PCP, a telehealth service, whatever) than who your PBM is.
posted by amelioration at 3:43 PM on July 31 [5 favorites]

Response by poster: Amelioration thanks! So helpful.
posted by bookworm4125 at 4:08 PM on July 31

Amelioration, I had no idea Caremark did this, despite being an avid CVS app user. Mind blown!
posted by chesty_a_arthur at 4:16 PM on July 31

I am on Rybelsus, the pill form of Ozempic, for type-2 diabetes. I also have Aetna. I get a month's worth through my local Kroger (Fred Meyer) pharmacy for $25 a month. However, just as a personal aside, I find the gastrointestinal side effects unpleasant, so I'm talking with my doctor about discontinuing, though I'm definitely seeing lower blood sugar and some weight loss due to my appetite being suppressed (not related to the stomach difficulties, I don't think).

My understanding that that the difference between diabetes-treating semaglutides and weight-loss semaglutides is branding, but I could be wrong there.
posted by lhauser at 5:33 PM on July 31 [1 favorite]