For the beneficiary to qualify, a provider must submit a prior authorization request to the program that attests the beneficiary is prescribed the requested drug to reduce excess body weight and maintain weight reduction in combination with current and ongoing lifestyle modification including structured nutrition and physical activity consistent with the applicable FDA approved label, and the beneficiary is at least 18 years of age with a BMI greater than or equal to 35. For beneficiaries with underlying medical conditions, the BMI threshold is lowered to 30 or 25 based on the diagnosis
Some insurance plans will cover the drug for $25 per month out of pocket.
As Dr Gabrielle Lyon points out, most patients treated for obesity have low muscle mass, which can worsen their condition (1)
TNF-alpha, interleukin-6 (IL-6), interleukin-1-beta (IL-1B), and interferon-gamma (IFN-gamma) drive persistent inflammation that damages tissue over time
Its a great thing to combine with exercise if you are like me and have a bmi over 25
Hama, R., Kido, J., Sugawara, K., Nakamura, T