If you dont have diabetes or obesity, youre probably not going to get insurance to cover your prescription for these drugs, however, which can cost over $1,000 a month
PMID: 32089476
Weight-related health conditions that support eligibility at BMI 27 to 30: High blood pressure (hypertension) Type 2 diabetes or prediabetes Sleep apnoea (obstructive sleep apnoea) Cardiovascular disease (heart attack, stroke, heart failure) Dyslipidaemia (high cholesterol or triglycerides) Non-alcoholic fatty liver disease (NAFLD) Polycystic ovary syndrome (PCOS) with metabolic features Osteoarthritis affecting weight-bearing joints Absolute contraindications mean Mounjaro is not safe to prescribe regardless of weight: Personal or family history of medullary thyroid carcinoma (MTC) Multiple endocrine neoplasia syndrome type 2 (MEN-2) Hypersensitivity to tirzepatide or any excipient Pregnancy or active attempt to conceive Breastfeeding Relative contraindications require careful assessment and may rule out treatment: History of pancreatitis Severe gastrointestinal disease including gastroparesis Diabetic retinopathy with recent worsening Severe kidney impairment (CKD stage 4 to 5) Severe liver disease Active eating disorder including bulimia nervosa History of suicidal ideation or active mental health crisis Type 1 diabetes (Mounjaro is licensed for type 2 only) Specific medication interactions require dose review: Oral contraceptive pills may have reduced effectiveness during dose escalation Insulin and sulphonylureas require dose adjustment when combined with Mounjaro Warfarin requires INR monitoring after starting The eligibility assessment at The Wellness is a structured 30-minute consultation including detailed medical history, medication review, BMI confirmation, blood pressure measurement, and baseline blood tests covering HbA1c, kidney function, liver function, lipid profile, thyroid function, and amylase or lipase
CVS dropped Eli Lillys obesity drug Zepbound from the list of medicines it covers for reimbursement
a dedicated MASLD/MASH Phase 2b trial is ongoing, but peer-reviewed Phase 3 data are still awaited
