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Combination therapies may be able to support higher prices by showing better results

Perimenopause and menopause The metabolic disruption of the menopause transition worsening insulin resistance, increased visceral adiposity, destabilized blood sugar is frequently undertreated

step therapy required BCBS of Illinois Covered with PA BMI criteria + documented diet/exercise failure BCBS of Michigan Not covered (fully insured) Removed all GLP-1 weight loss drugs from commercial plans Jan 2025 BCBS of Florida (Florida Blue) Covered with PA BMI 30

IBS-M, IBS mixed type

New platform lets plan sponsors test obesity drug coverage without rebate complexity Eli Lilly is testing whether a flat US$449 price for its obesity drug Zepbound can finally make GLP1 coverage workable for more employer plans