ArticleThe American journal of managed care2025
Understanding insurance coverage policies for incretin mimetics for weight management.
Article in The American journal of managed care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The trial behind it
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Who cites it
3 citing papers in PubMed.
- Integrating incretin-based therapies into comprehensive obesity care: an EASO position statement.The Lancet regional health. Europe · 2026Review
- A survey of primary care physicians' views on supporting patients who lose insurance coverage for Glucagon-Like Peptide-1-based drugs for weight management.Obesity pillars · 2026Article
- State-level variation in the use of glucagon-like peptide-1 receptor agonists for weight loss and diabetes: a real-world analysis.Journal of managed care & specialty pharmacy · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectivesGiven the wide variation in insurance coverage for incretin mimetics for weight management (IMWM) in the US, we aimed to understand (1) coverage policies for IMWM and influencing factors, (2) coverage policies for other weight management treatments, and (3) opportunities to support weight management while constraining health care costs. STUDY
designQualitative study.
methodsParticipants were leaders and high-level employees from large health insurance organizations in the US. Our aim was to survey 20 participants, 10 from organizations that covered IMWM and 10 that excluded coverage for IMWM. Participants completed a 30-minute interview. Interviews were audio recorded, transcribed verbatim, and analyzed using directed content analysis.
resultsTwenty individuals completed an interview; 9 interviewees were from organizations that covered IMWM at the time of the study, and 11 were from organizations that excluded coverage for IMWM. We identified 5 key themes: (1) high cost as the primary barrier to coverage of IMWM, (2) perception of obesity as a lifestyle choice, (3) current or planned use of varied utilization management strategies to limit initial and ongoing prescribing of IMWM, (4) coverage for lifestyle-change programs to support weight management, and (5) perceived responsibility of pharmaceutical companies to lower list prices for IMWM to enable broad coverage and advance health equity.
conclusionsHigh cost of IMWM is the primary limiting factor in coverage policies. There is variability in plan design, with utilization management strategies that aim to reduce near-term spending. Health plan leaders call on pharmaceutical companies to reduce list prices to increase equitable access to IMWM.
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Registered trials
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