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ForumsInsurance & Access2026 payer coverage update — GLP-1 formulary changes by insurer Page 6

2026 payer coverage update — GLP-1 formulary changes by insurer

InsuranceTom Mon, Feb 26, 2024 at 4:00 PM 481 replies 19,062 viewsPage 6 of 20
SleepDoc_PDX
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Sep 2024
Portland, OR
Feb 27, 2024 at 12:30 AM#26
nick_SD_fit said:
This community is amazing

This is exactly right. nick_SD_fit articulated what I have been trying to explain to my doctor for months. The 2026 payer coverage aspect is the most important factor.

Last edited: Feb 27, 2024 at 3:30 AM
24 23pete_nash, hank_denver, carlos_SATX and 21 others
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dan_philly
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Jul 2024
Philadelphia, PA
Feb 27, 2024 at 12:47 AM#27

Saving this for reference. Top-tier content.

4 21AmyNC_wife, SkepticalSean, Dr.CardioMD and 1 other
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claudia_zurich
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Jul 2024
Zurich, CH
Feb 27, 2024 at 1:04 AM#28

As a pharmacist, I want to add some clinical context to this discussion on 2026 payer coverage update GLP-1.

Building on what nick_SD_fit said — the evidence base here is robust. The key publications to reference are from the FLOW program[1].

Key clinical points:

  1. Efficacy is dose-dependent and typically requires 4-5 weeks to reach steady state
  2. Side effect profile is predictable and usually manageable with standard protocols
  3. Monitoring should include baseline labs and follow-up at 3-month intervals
  4. Patient education significantly improves outcomes and adherence

Standard disclaimer: this is educational, not individualized medical advice.

References:
[1] See thread title for relevant study identification.
Last edited: Feb 27, 2024 at 7:04 AM
45 19Dr.LipidDallas, alex_tucson, kevin_tulsa and 42 others
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cory_ATX
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2,123
Jul 2024
Austin, TX
Feb 27, 2024 at 1:21 AM#29

Reading this thread on 2026 payer coverage hits close to home. Dad of 2 checking in — I started at 265 lbs and felt like I would tried everything.

11 months on tirz and I am a different person. Not just the 40 lbs lost — my energy, my mood, my relationship with food. All transformed.

If you are on the fence about 2026 payer coverage — take the leap. It was the best health decision I have ever made. ❤️

44 16Dr.PathRoch, mona_PHX, andrew_nyc and 41 others
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patPC_UT
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Nov 2024
Park City, UT
Feb 27, 2024 at 1:38 AM#30

Congrats claudia_zurich!! Keep going — you're doing incredible. 🎉 👏

33 16julia.endo, JessicaM_2024, TomFromTexas and 30 others
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