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What the FDA approval of Zepbound for obesity could mean for you

Angela Fitch
Nov 9, 2023

The FDA announced its approval of Eli Lilly’s Zepbound for adults with obesity on Wednesday, November 8th. As with other news surrounding GLP-1 medications (such as Ozempic, Wegovy and Mounjaro), we want to ensure that you are educated on what potential effects it could have on your care plan.

At knownwell, we believe that medication choice needs to be individually tailored as the efficacy of weight loss medications varies greatly from patient to patient and is often unpredictable.  With that being said, we know many in our community are eager to learn how this news will affect them and we hope this post will answer some of your most pressing questions.

What is Zepbound and how could it affect my treatment?

Zepbound is an injectable medication that activates both the GLP-1 and GIP receptors to promote weight loss by multiple mechanisms in the human body helping adults with obesity. It is the weight loss version of its sibling, Mounjaro. The difference in these medications lies in which disease state they are approved to treat. Otherwise, the chemical make-up is the same.  

Zepbound is the most effective FDA-approved pharmacotherapy treatment for obesity to date and so for patients that have a greater amount of weight to lose, this may be the best option if they are looking for non-surgical treatment.  Zepbound may have different side effects than other obesity medications, which is also a benefit for patients as they now have multiple options to treat obesity, and one medication may be tolerated better than another.

Is Zepbound better than other options?

Effects of this medication class vary substantially by person. In the results report from Eli Lilly’s clinical trials, the data suggests that Zepbound has the potential to be more effective than other weight loss medications on the market. While Zepbound displayed these positive results, it does not mean that it will work better than alternative options for everyone.

What are the side effects of Zepbound?

The side-effects of Zepbound are like those of Mounjaro and other medications in the GLP-1 drug class. We would recommend reading the medication guide on Eli Lillys website for the full list, then discussing whether you may be affected with your prescribing clinician.  

When will I have access to Zepbound?

It is important to remember that yesterday's announcement was only about the FDA approving Zepbound. It will not be available on the market until mid-December.

Some insurance plans may take until January to update their formulary, so not everyone who calls their insurance company in December may get a clear answer as to if Zepbound is covered by their plan.

Will my insurance plan cover Zepbound?

Unfortunately, this is not a simple yes or no question. For commercial insurance plans, what a plan covers is decided entirely by a patient’s employer. Companies that have not changed their plan in years are less likely to have coverage due to how new these drugs are. With the publicity these drugs have received this year, employers may feel more pressure to cover them over time. If your plan does not currently cover Wegovy, it’s unlikely (but not impossible!) that the plan will cover Zepbound.  

We always encourage patients to go to their HR/Benefits team and ask for them to consider covering drugs for the treatment of obesity.

Unfortunately, neither Medicare nor MassHealth (Medicaid-MA) currently cover anti-obesity medications, though the Treat and Reduce Obesity Act is sitting with congress to expand Medicare’s coverage. If Zepbound is not covered by your insurance, there will be a coupon that will make the price $550 per month if the drug is not covered by the insurance. However, this coupon cannot be used by patients with Medicare or Mass Health/Medicaid plans.

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