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Effective January 1, 2026, Medi-Cal Rx is excluding coverage for GLP-1 medications prescribed for weight loss: [12] Wegovy, Zepbound, Saxenda: Completely removed from the Contract Drugs List for weight loss Ozempic, Mounjaro, Rybelsus: Restricted to Type 2 diabetes onlyweight loss claims will auto-deny Existing prior authorizations end December 31, 2025 Exceptions: Members under age 21 may still qualify via EPSDT Non-weight-loss indications (Zepbound for OSA, Wegovy for cardiovascular) may still get PA approval This does NOT affect Kaiser commercial or employer-sponsored plansonly Medi-Cal members
They are designed for different patients
Wegovy / Ozempic) Semaglutide is a potent, long-acting GLP-1 RA available as a weekly injectable
More recently, the SELECT trial showed that semaglutide 2.4 mg reduced major adverse cardiovascular events in adults with overweight or obesity without diabetes
Exendin-4, a GLP-1 Receptor Agonist, Attenuates Prostate Cancer Growth
Clinical trial eligibility Is the patient potentially eligible for any ongoing retatrutide trials, and would referral to a hepatology or metabolic medicine specialist be appropriate
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