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UHCs typical prior authorization requirements for Wegovy and Zepbound include: BMI documentation A documented BMI of 30 or higher, or BMI of 27 or higher with at least one weight-related comorbidity such as type 2 diabetes, hypertension, dyslipidemia, or obstructive sleep apnea Comorbidity evidence Clinical records documenting the specific comorbidities that support the medical necessity of treatment Supervised weight management history Evidence of participation in a structured weight management program, which may include diet, exercise, and behavioral counseling, typically for 3 to 6 months prior to the request Prescriber qualifications The prescriber must be a physician, nurse practitioner, or physician assistant with appropriate prescribing authority UHC reviews prior authorizations against specific clinical policy bulletins
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Wegovy tablets (up to 25mg) are specifically developed and trialled for weight management in adults with obesity or excess weight
This prolonged gastric emptying not only aids in blood glucose control but also enhances feelings of satiety, leading to reduced caloric intake and weight loss
Small increases in the costs of treating cardiovascular and renal complications with oral semaglutide versus dulaglutide were due to increased survival of patients over the long term, who required further treatment of costly complications such as peripheral vascular disease, myocardial infarction and end-stage renal disease
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