Glucagon-Like Peptide 1 (GLP-1) Agonists for Weight Loss: Drug Shortages and Labeled Indications
Date: 05/16/23
GLP-1 agonist medications have been approved for the treatment of type 2 diabetes, prevention of cardiovascular disorders in patients with type 2 diabetes, and weight loss.
A rise in social media awareness of GLP-1 agonists as a weight loss solution has led to increased demand. As a result, there has been a national shortage, and patients with type 2 diabetes have had difficulty mantaining treatment.
Semaglutide and liraglutide are GLP-1 agonist medications. Semaglutide has several formulations including Ozempic® (type 2 diabetes), Rybelsus® (type 2 diabetes), and Wegovy® (weight loss). Liraglutide has formulations including Victoza® (type 2 diabetes) and Saxenda® (weight loss). A newly approved medication, Mounjaro® (type 2 diabetes), has emerged as well. Although semaglutide and liraglutide have formulations that are FDA-approved to treat obesity, Mounjaro is only FDA-approved for treatment of type 2 diabetes. There will continue to be a high number of requests for many of these products, often used for weight loss alone, which is a non-covered benefit.
Below is a reference chart for GLP-1 agonist medications. Please evaluate your patients to ensure they are utilizing the medications appropriately and as indicated. Coverage and formulary restrictions are set by the Arkansas Medicaid Preferred Drug List for Ambetter.
Medication | FDA-Approved Indication | Dosing Frequency and Route | Ambetter Coverage
|
|---|---|---|---|
Dulaglutide (Trulicity®) | Type 2 DM | Once weekly SQ injection | Non-preferred
|
Exenatide, extended release (Bydureon BCise®) | Type 2 DM | Once weekly SQ injection
| Non-preferred (Bydureon BCise only)
|
Exenatide (Byetta®) | Type 2 DM | Twice daily SQ injection | Preferred*
|
Liraglutide (Victoza) | Type 2 DM | Once daily SQ injection | Preferred*
|
Liraglutide (Saxenda) | Obesity | Once daily SQ injection | Non-covered benefit
|
Lixisenatide (Adlyxin®) | Type 2 DM | Once daily SQ injection | Non-preferred
|
Semaglutide (Ozempic) | Type 2 DM | Once weekly SQ injection | Non-preferred
|
Semaglutide (Wegovy) | Obesity | Once weekly SQ injection | Non-covered benefit |
Semaglutide, oral (Rybelsus) | Type 2 DM | Once daily tablet | Non-preferred
|
Tirzepatide (Mounjaro) | Type 2 DM | Once weekly SQ injection | Non-preferred
|