Which GLP, from where, at what cost?
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Anonymous
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Please help me. I have decided to try a GLP med. I have consulted my PCP, my endo, my endo surgeon, my psychiatrist and my oncologist. All agree this is a good plan. I have an RC for tirzepatide/zepbound, because that is what I asked for, but I am open to try other GLPs if they cost less & I’m pretty sure the doc where Rxed the Zepbound would switch it to semaglutide if that is what I could afford.
I do not think my insurance will cover this, even though I am obese (30.5 BMI) and have high cholesterol (300) and sleep apnea. My read of the plan and formulary is that my BCBS HMO plan on the MD ACA exchange doesn’t cover weight loss at all and neither tirzepatide nor semaglutide are on the formulary. Although liraglutide is on the formulary, that might only be for diabetics, which I am not. If I purchase from Eli Lilly direct and self-pay, the cost is $349 for the first month and $499 for each month after. TBH, that is unsustainable for me. So, at the encouragement of one of my doctors (head of service at a major academic hospital), I am open to trying a compounded GLP. But, I am overwhelmed figuring out costs. If you are self-paying for a GLP med, can you please share - what is the medication? where are you getting it (name of online company, pharmacy, etc.)? What does the medication cost per month? Are there additional monthly fees for doctor visits or memberships or coaches or shipping, etc.? How much do you have to commit, i.e. if you are paying $200 a month is that only because you have to commit for 6 months? Are there other costs I should be thinking about? |
Anonymous
| Started on a compounded semaglutide in January, it's been refilled once. I pay out of pocket, so I didn't want name brand! $400 for each vial. It's time for a refill and the pharmacy can't make compounded anymore, so they suggested I switch to a sublingual tablet that you do twice a day and it's less than $200 per month. So it might be a bit more but they're seeing great results because it's a continuous delivery of med instead of an injection to last a week. Also less side effects (nausea, constipation) |
Anonymous
| Oh, I haven't required any follow up appointments, my GP prescribes to a local pharmacy. I've lost 35# so far |
Anonymous
| Insurance often covers Zepbound for sleep apnea. Do you have a diagnosis? |
Anonymous
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Brello. $500 for a three month supply, any dosage. No other hidden fees. I’ll be receiving my next three month supply soon. My biggest hurdle was the thought I’d have to give myself a shot. It’s nothing though!
I’ve heard the pills don’t work as well and I’m not spending money on something that doesn’t work. I intend to microdose for a while. I’m currently in 2.5 and while it’s still working, I’ll stay there. I asked for a higher dose but that’s just because I’ll then have more for the same amount of $$. |
Anonymous
| Why won’t your insurance cover it? I am only slightly overweight and mine (Cigna) covers it |
Anonymous
As I said in my OP, my plan only covers medications on a formulary list (which doesn’t include GLP meds) and my plan has a number of broad prescription weight loss exclusion provisions. I’m pursuing if I can get an exception based on a non-weight loss reason, but it’s very unlikely. I really don’t want to turn this thread into an insurance thread. If I need advice on insurance I’ll post separately. I’m focused on sources for the lowest cost compounded semaglutide or tirzepatide, because I believe I’ll have to end up self paying. Thanks for any source/price shares. |
Anonymous
| $500 a month is not bad, I was paying $1000 a month for compound because insurance wouldn’t cover it. |
Anonymous
I was paying $275 for a vial of compounded GLP. The problem is GLP is no longer allowed to be compounded as of 1-2 months ago. I stocked up in advance (I use Eden) but I think pharmacies are still trying to figure it out. So it may be a little harder to get an answer right now because of recent changes. Look at Eden and see what they say. Most of the online sites were similarly priced. |
Anonymous
| Brello. Still compounding. |
Anonymous
| Your doctor should work with your insurance to get a prior authorization. You shouldn't still be wondering at this stage, they should be helping you get this medicine that they prescribed and agree is necessary. |
Anonymous
Thank you. This wasn’t a question about insurance. It was a question about self-pay for GLP meds. Thanks to the other PPs who provided info on Brello and Eden. Are there any other suggestions for compounded GLPs with specifics about providers and price? |
Anonymous
My sister’s Cigna does not cover any of them for weight loss so it depends on your plan. |
Anonymous
| I used Fifty410 for a 3-month supply, I think it was about $600. I believe they are still compounding and selling. I haven't run out yet. |
Anonymous
| $349 isn’t too bad. I was paying a little over that for Wegovy until BCBS began offering mail order for it but if I didn’t have that option I’d pay the $350 or more for a GLP-1. It’s worth it. If you want cheaper then mochi offices reasonably priced compound GLP-1. I joined them initially but ended up canceling to take the manufacturer version instead once I found out my PCP could prescribe it. But Mochi was an easy option and many ppl are pleased with their compound products |