semaglutide approved for obesity A big win Wegovy: Weight loss drug first in history to gain FDA approval for reducing heart risks Semaglutide, also known as Ozempic,

Compounded semaglutide is becoming more popular as people search for alternatives to expensive medications like Ozempic

Dont want to deal with telehealth and prefer in-person care

Medical Necessity Checklist for Formulary Exception If you're requesting a formulary exception, gather this documentation first: Required Documentation for Exception Request Current BMI documentation (30 or 27 with comorbidity) Documented comorbidities with ICD-10 codes: Obesity Class I/II/III (E66.811, E66.812, E66.813) Hypertension (I10) Type 2 Diabetes (E11) Dyslipidemia (E78.5) Obstructive Sleep Apnea (G47.33) Failed alternative treatments documented trials of: Phentermine or diethylpropion Qsymia or Contrave Semaglutide (Wegovy/Ozempic) for 6+ months Lifestyle modification records (diet/exercise program participation) Weight history showing chronic obesity (past 1-2 years) Letter of Medical Necessity from your Kaiser provider For more on prior auth documentation, see our Zepbound prior auth checklist EXCEPTION PATHWAYS How Some Members Get Coverage While standard coverage is limited, some Kaiser members do get Zepbound covered

10.1136/thx.22.1.88 112 LappalainenU.WhitsettJ