Popular GLP-1 drugs, including Ozempic and Wegovy, are gaining traction as effective weight-loss treatments, with many calling them “miracle drugs.” However, their rising popularity is putting pressure on healthcare spending, leading some insurance companies, like Blue Cross Blue Shield, to reduce coverage.
Blue Cross Blue Shield reported that five GLP-1 drugs accounted for nearly 20% of its pharmacy expenses. These medications cost between $950 and $1,400 per month. In response to growing costs, certain coverage plans are changing, creating challenges for doctors in Massachusetts.
Physicians like Dr. Richard Siegel from Tufts Medical Center are struggling to keep up with the demand. “It’s a changing environment, and it’s frustrating when patients who have seen positive results suddenly find they can’t continue the medication due to insurance restrictions,” Siegel explained. He noted that patients who have experienced better health and lower healthcare costs are now facing barriers due to insurance authorization issues.
GLP-1s, which are designed to manage weight, have proven effective for many patients, offering better results than other medications in the long run. One such patient, Rachel Ferdinand, shared her experience. “Even on the lowest dose, it’s completely changed things for me. I’m hopeful,” she said. However, Ferdinand expressed concern over insurance companies only covering these drugs for diabetes, not weight loss. “It’s always in the back of my mind,” she added, noting that her doctor had raised the issue.
Dr. Siegel emphasized that GLP-1 drugs have helped patients lose more weight over a six to twelve-month period compared to other treatments. He also hopes that new, effective medications will emerge to help drive prices down.
Ferdinand expressed disappointment over the potential barriers to accessing the drugs she needs. “It’s disheartening, though not surprising, given the state of medical coverage in the U.S.,” she said.
In response to the issue, the Massachusetts Division of Insurance has issued guidance allowing health plans to exclude coverage for weight loss treatments with GLP-1 drugs in their 2026 offerings.
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