If it hasn’t become obvious to you, it will soon—medicine is a mess. Let’s start with getting your medications. Many of us are aware that since the COVID lockdowns started, there have been supply chain issues affecting our food, our home supplies, our clothing…you name it. Medicine is no exception.
Whether it’s getting the ingredients to make the medications, getting the employees to work at the manufacturing sites, getting the medications distributed to pharmacies, or getting the employees needed to write and dispense the medications—it’s very clear that things are not working right. As a result, especially when it comes to popular injectable weight loss medications, the supply of appropriate dosages of specific medications remains a moving target.
So what are you supposed to do? You’ve finally found a solution that has led to excellent weight loss, and right smack in the middle of your rising success, the rug is pulled out from under you. How?
A coupon expires. Your pharmacy doesn’t have your medication in stock or doesn’t have the dose you need. Your insurance company suddenly decides not to cover your medication that was previously approved…
These are frustrating times for both patients and their physicians, I assure you, but do not give up the fight! Here are some ways to navigate through the shark-infested waters.
What To Do If Your Pharmacy Does Not Have Your Dose
1. Pharmacy Shop
Just because your regular pharmacy doesn’t have what you need, it does not mean that another one nearby will have the same issue. Call around and when you find a pharmacy carrying your dose, have your physician call it into that pharmacy. Although this isn’t always a long-term solution, it will at least keep you moving forward in the right direction. We have found that smaller, more local pharmacies seem to have better supplies than the larger conglomerates, which really surprised us.
2. Take the Available Lower or Higher Dose
Although this is not ideal, it is an option. When it comes to injectable weight loss medications, results are dose-dependent. This means that if you choose the lower dose, your weight loss might slow down or stop altogether. You should, however, maintain your weight loss.
If you have been on your current dose for 4 weeks, and the next higher dose is available, it is preferable to step up to the higher dose instead of going back down. I never advise skipping ahead past the next dose you are on, however, because the side effects are much worse.
3. Consider the Compounded Version of the Medication (Applies to Semaglutide Only)
When it became clear that there was an issue with the national supply of Semaglutide (commonly known as Ozempic & Wegovy), the FDA approved the production of Semaglutide by compounding pharmacies. A compounding pharmacy creates custom medications from base ingredients for patients. Rather than providing a pre-mixed formula, the compounding pharmacist begins with base drugs, combining and preparing them to fit the individual patient’s needs.
Although it is still a little pricey, compounded Semaglutide is about a ¼ to ½ the cost of the uncovered pharmaceutical price depending on your dose, and what the prescribing physician’s office charges. You can discuss this option with your physician, or call a compounding pharmacy and see which local physicians are writing the medication. With compounding pharmacies, remember that each state has different rules as to how they write and/or dispense these medications.
What To Do If Your Coupon Runs Out Or You Lose Coverage
1. Check Out a Pharmaceutical Website
For Ozempic and Wegovy, go to Ozempic.com or Wegovy.com. On these sites, they will calculate the cost of the medication and coverage for you after having you answer just a few questions. Make sure you scroll all the way to the bottom, however, because it may say “covered” but the cost to you at the bottom of the paragraph can be anywhere from $25 to $1200 plus.
2. Contact Your Insurance Company
If you’ve had excellent weight loss on Mounjaro for example (whose coupon is iffy right now), you can connect with an advocate from your health insurance company and see what your options are. Sometimes they will cover a different medication, or require a letter from your physician’s office detailing your success. At our office, we have had physician-to-physician conversations with the Medical Director of a plan and successfully advocated for our patients to continue or obtain coverage for a medication that has worked for them. When it comes to success on a medication, no doesn’t always mean NO.
3. Consider the Compounded Version of the Medication (Applies to Semaglutide Only)
As detailed above, compounded Semaglutide is about a ¼ to ½ the cost of the uncovered pharmaceutical price depending on your dose, and what the prescribing physician’s office charges. You can discuss this option with your physician, or call a compounding pharmacy and see which local physicians are writing the medication.
4. Look On GoodRX and See Which Pharmacies Offer the Lowest Cost Alternative
If you are not familiar with the GoodRx app, this would be a good time to download it to your phone. GoodRx searches local pharmacies and finds you the best out of pocket price for your medication. With the injectables, this might still be extremely high, but it gives you the option to compare prices.
5. Consider a Different Medication That Is Less Expensive
Although injectable weight loss medications give excellent results, they are not the be-all and end-all. As an Obesity Medicine Physician who has been in the field for over sixteen years, I know that injectables offer more options, but not necessarily better results. My first line weight loss medication, Phentermine, is still the cheapest alternative, at a monthly out of pocket cost of $25 or less. Phentermine is safe, effective, and can be taken long-term. There are other medications out there that are equally effective and equally inexpensive that are also taken by mouth. Stay tuned for future articles, where we’ll explore alternatives to injectables that are similarly safe and effective!
1 Comment
Good Afternoon,
I am interested in speaking with you regarding weight loss. I am 57, very active, eat a pretty clean diet, still cannot loose weight. I’m pretty discouraged and would love to find out what can be done. I look forward to speaking with you.