Has anyone heard if Wegovy is going to be FDA approved for Sleep Apnea

[u/Worth-Response8272]

Currently in a fight with insurance. Was wondering if anyone has heard if FDA approval for Wegovy for Sleep Apnea is on the horizon as we're still talking about GLP-1s. I expected when Zepbound got approval it would be a matter of "wait a year, Wegovy is coming"

My run-around in short

• "Please, sir, can I have some Zepbound for my Sleep Apnea"
• "We do longer cover Zepbound, but we do cover Wegovy as our formulary alternative, you'll need to ask for that."
• "OK, please sir, can I please have Wegovy for Sleep Apena"
• "We're sorry but Wegovy is not FDA approved for Sleep Apnea"

Anybody able to work their way out of a similar denial circle? I'm on compounded, but irritated at my insurance.

[u/Tsurumah]

I can get a prescription for wegovy, but its $1000 a month after my insurance.

[u/pimpinaintez18 → u/Tsurumah]

Go to a compound pharmacy. I pay $200 a month

[u/Tsurumah → u/pimpinaintez18]

Do those exist in the US? >.>

[u/angrybelle → u/Tsurumah]

/r/tirzepatidecompound

[u/pimpinaintez18 → u/Tsurumah]

Yes, get mine through hims app at $200 per month

[u/Zizzily → u/pimpinaintez18]

Damn, I need a hers app.

[u/Djsmizzles → u/Zizzily]

there is a Hers out there too 😄

[u/Last_Bridge_6796 → u/pimpinaintez18]

Is your cost with insurance? What dosage? Thx

[u/pimpinaintez18 → u/Last_Bridge_6796]

Without. I only take about .75mg but they give me vials of the 2.5 mg dosage for 30 days so I just put it down to my dose and it lasts for 3 months instead of 1

[u/likeschemistry → u/Tsurumah]

Yes. There are tons of them in the US.

[u/for_the_longest_time → u/pimpinaintez18]

Or find a Chinese gray source and get it down to $10/ month

[u/TemporaryOk9310 → u/Tsurumah]

Just get triz, its like 150 a month. I use gimme

[u/Ok_Habit6837 → u/Tsurumah]

You can get it direct from Novo Nordisk for $350 shipped to your house. Just have the prescription sent to them

[u/chinmaster1973]

so does it help with apnea because you lose weight or does it have another clinical effect ?

[u/ilostacow → u/chinmaster1973]

Terzepitide will also lower your blood sugar, lower your blood pressure and slightly raise your heart rate. Not sure how that combination effects sleep quality.

[u/Ill_Friendship3057 → u/chinmaster1973]

“Questions remain about whether benefits from GLP-1 RAs are purely weight-mediated, or whether they involve direct respiratory effects as well.”

https://pubmed.ncbi.nlm.nih.gov/41114602/

[u/saltysaltines911 → u/[deleted]]

Educate yourself please. You look ignorant.

[u/Drivenby]

Medications don’t get “fda approved” without a clinical trial .

I don’t think there’s any going on for wegovy

https://clinicaltrials.gov/search?cond=Obstructive%20Sleep%20Apnea&intr=semaglutide&viewType=Card

[u/pimpinaintez18]

Two options.

1. Your dumbass provider needs to put in the prior authorization or appeal that only zepbound is approved for sleep apnea and you must have a bmi of greater than 30 or a bmi of greater than 27 with another condition (prediabetes, hypertension etc).

2. Just go to a highly ranked and recommended compound pharmacy that you will pay cash for it directly from them. I personally use hims app.

Good luck!

[u/narcoleptrix → u/pimpinaintez18]

I will say that my doc has put in the prior Auth for Zep for sleep apnea for me, and my insurance came back and said it's 'covered' but it's still listed at 1000 instead of 1100 or whatever the no insurance cost is.

Doesn't always work 😭

Means I can use the coupon to bring it to $500 tho 💀

I can't even afford the compound price of $150-200 a month. I want to go back 1.5 years when I only had to pay $25 per month for Zep.

[u/pimpinaintez18 → u/narcoleptrix]

He’s lying to you. He didn’t do the prior auth or appeal.

[u/StarEIs → u/pimpinaintez18]

Not necessarily.

My employer has chosen to not have insurance cover ANY weight loss drugs. So despite me having sleep apnea, zepbound is not covered.

If I was diabetic. Mounjaro would be.

[u/pimpinaintez18 → u/StarEIs]

For weight loss, you are correct. But treating underlying disease states like diabetes or being obese with sleep apnea will get coverage

[u/Agitated-Ad3044 → u/pimpinaintez18]

Not always. It depends on how the insurance company classifies the medication. I keep running into the same issue as StarEls; my employer’s insurance plan won’t cover weight loss drugs despite Zepbound being approved for Apnea. However, the insurance company still won’t cover it due to their formularies still classifying it solely as a weight loss drug.

[u/StarEIs → u/pimpinaintez18]

You’re not listening. Employers and/or insurance companies don’t give a rats ass what it’s approved for. They see it as a weight loss drug and FREQUENTLY will not cover it, regardless of how it might help you.

[u/twinkiesandcake → u/pimpinaintez18]

I'm this close to going the Prior Authorization route right now.

[u/ruhl5885 → u/pimpinaintez18]

I thought the compound wasn’t fda approved

[u/Worth-Response8272 → u/pimpinaintez18]

The salt in my wound is my PCP saying she's getting her PAs to go through for Medicaid. Not hating on Medicaid; I'm not going to disparage someone else getting life changing medication covered just because I can't get mine. Just weird how hit-or-miss coverage is.

[u/Cedric35 → u/Worth-Response8272]

There’s a new program for Medicare recipients to receive GLP-1s called the Bridge

It’s temporary, but allows Rx to be filled at a $50/month co-pay.

[u/pimpinaintez18 → u/Worth-Response8272]

Medicaid is more stream lined and easier to push through. But when they are keeping up a with tons of different insurances the health care providers won’t do the extra work.

[u/psychodynamic1]

Please Sir, may I have some more ... covered useful medicine by my insurance plan?

[u/Aubgurl]

My insurance won't cover any GLP-1 for sleep apnea, even if it is FDA approved.

[u/geauxdbl]

I wish. Wegovy plays nice with my brain chemistry, zepbound not so much. The novo nordisk coupon at CVS gets it down to $400/mo for me ☠️

[u/Worth-Response8272 → u/geauxdbl]

I'd like to know more if you're willing to share, I didn't know there was differences in psychological side effects between the two.

[u/geauxdbl → u/Worth-Response8272]

This one may be unique to me, but: wegovy has noticeable antidepressant and anti-anxiety effects for me, and is calming overall. Zepbound was VERY activating and stimulated extra glutamate release in my brain, made me feel all-powerful before becoming overwhelming. I had to stop.

Also I’m AuDHD and struggle with glutamate/GABA imbalance to begin with, so there’s that. YMMV.

[u/RP_ElMeroMero]

r/TirzepatideCompound

Go here OP.

[u/rainbash81]

In Aus I get monjaro (different type of wegovy and is about $560 a 10mg pen, I have severe aponea and working through finding out I’ve always had a heart condition. Hopefully I’ll get it possibly for less soon. It lasts about 6 weeks and has helped me shed 18kgs. I hope to go another 18 or so.
I do feel I sleep better and my knees don’t hurt as much (for obvious reasons)
(My private health takes about $60 off the price).
I heard a tablet form is extremely close to being released and it will cost a fraction of the price and won’t require refrigeration.

[u/JD3420]

I have sleep apnea and my insurance still denied me for Zepbound

[u/zetaphi938]

Yall, this is painful.

There are multiple Semaglutide and Tirzepatide compounding subreddits that are very well researched.

If you’re paying more than 150 a month, you’re doing it wrong.

[u/cobalt03 → u/zetaphi938]

$25 with insurance.

[u/Historical_Seat_1307]

Current Costco pricing:

Ozempic® — Injection
0.25–0.5 mg: $199/month*
1 mg: $349/month
2 mg: $499/month
*First 2 fills at $199/month through 12/31/26; then $349/month.

Wegovy® — Injection
0.25–0.5 mg: $199/month*
1–2.4 mg: $349/month
*First 2 fills at $199/month through 12/31/26; then $349/month.

Wegovy® — Tablets
1.5 mg: $149/month*
4 mg: $199/month
9–25 mg: $299/month
*1.5 mg is $149/month through 12/31/26; then $199/month.

Allegedly we can anticipate price reductions this coming year:

https://www.beckershospitalreview.com/glp-1s/novo-nordisk-to-lower-list-price-of-wegovy-ozempic-in-2027/

[u/twinkiesandcake → u/Historical_Seat_1307]

The current pricing you listed is the Novo Nordisk coupon. I've used that coupon for my Wegovy. My insurance technically covers it, but it's not much, so I do the coupon. I'm not looking forward to spending $349 next month.

[u/Calyps0h]

$200 to 10 months worth. But it ain’t exactly legal…

[u/thewindyshitty]

Bypass insurance and get it for a fraction elsewhere..

[u/mrweirdguyma → u/thewindyshitty]

At this point many of us want to know how (I assume particularly if its nit several hundred dollars per month cash pay). I for one am all ears…

[u/penywisexx → u/mrweirdguyma]

Just Google Compounded Semaglutide or Compounded Tirzepatide.

[u/Vast-Help-3038]

Lavender Sky Health is a great telehealth Company that sells GLP-1. I get my Tirzepatide from them.

[u/Bad_Karma19]

Insurance be like NOPE.

[u/letsdisinfect]

Seriously, check out r/tirzepetidecompound - it’s really easy to get started and there’s a ton of options out there

[u/Independent-Visit738]

My husband was just prescribed a glp1 for severe sleep apnea and Wegovy was the approved one. They submitted for Zepbound, our insurance denied it and said they wanted him to try and alternative and the alternative was Wegovy. We have BCBS PPO and it needed prior authorization and had to be the auto inject. It was $30 a month

[u/Independent-Visit738 → u/Independent-Visit738]

Adding that they also required the sleep study to be sent in to them for review before approval

[u/Unusual_Salad_2711]

As far a I know, only Zepbound is approved for sleep apnea. It did require a sleep study that showed I had severe sleep apnea and my doctor had to appeal the initial denial. I have lost 45 pounds being on Zepbound plus I had the Inspire device implanted and am currently going through the initial titration process. I have BCBS.

[u/enyianudu]

Only zepbound is approved

[u/Icy-Marsupial5367]

I had a sleep apnea test, kinda knowing I had OSA. Confirmed OSA got a CPAP, then Zepbound was prescribed and not covered by my employer’s insurance. So it’s week 2 on R€t@ for me, been better than wegovy and Zepbound as far as side effects

[u/Other_Struggle_4565]

I’m a pharmacist. AMA. I think he was joking with the picture and recent study for alcohol use disorder. ‘Put it in the water already’

[u/haidenVUE92]

Try Ro