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Evidence-based GLP-1 & peptide discussion since 2023
ForumsInternationalSwitzerland BAG coverage — anyone have experience? Page 3

Switzerland BAG coverage — anyone have experience?

hank_denver Mon, Jul 22, 2024 at 6:40 AM 47 replies 3,019 viewsPage 3 of 10
DanielChem_CHI
Senior Member
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5,678
Mar 2024
Chicago, IL
Jul 24, 2024 at 12:48 AM#11
DebRD_ATL said:
Insurance update relevant to cost and coverage: I just got my prior auth approved through Anthem after 4 attempts.

Insurance coverage hack for cost and coverage: if your insurance denies brand Wegovy/Ozempic, consider these alternatives:

  1. Prior authorization appeal with peer-to-peer review
  2. Manufacturer copay card (for commercial insurance)
  3. Patient assistance programs (Novo Nordisk, Eli Lilly)
  4. Compounded medication from a 503B pharmacy ($126/month)
  5. Canadian pharmacy (requires prescription, ~40-60% savings)

Don't let cost prevent access to effective treatment. There are options at every price point.

3 3fiona_VT, denise_HTX, raj_cambridge
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KarenAZ_mom
Member
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Aug 2024
Scottsdale, AZ
Jul 24, 2024 at 9:11 PM#12
maria_elpaso said:
Financial impact of cost and coverage weight loss beyond medication cost: Groceries: SAVED $284/month (eating less) Restaurants: SAVED $214/month…

Thank you — that is the clearest version of this I have read, and I have read a lot of them.

2 2pete_manc_UK, anna.melb_AU
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Dr.GutHealth
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Minnesota
Jul 25, 2024 at 5:35 PM#13
DebRD_ATL said:
Insurance update relevant to cost and coverage: I just got my prior auth approved through Anthem after 4 attempts.
DebRD_ATL said:
...compounded vs brand cost and coverage...

This debate comes up weekly and I think both sides have valid points:

Pro-brand: FDA-approved, manufacturing standards guaranteed, clinical trial data directly applicable

Pro-compounded: 10x cost savings, same active molecule, independent testing available, accessibility

My position: if you can afford brand or have insurance coverage, that's the gold standard. If not, properly tested compounded from a 503B pharmacy is a reasonable alternative. Neither side should shame the other.

1 1jennifer_SEA
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Dr.PulmRoch
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2,345
Jun 2024
Rochester, MN
Jul 26, 2024 at 1:59 PM#14
hank_denver said:
Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the…

Telehealth prescriber review for cost and coverage: I've used 2 different telehealth platforms to get my GLP-1 prescription. Comparison:

FeaturePlatform APlatform BPlatform C
Initial Consult$57$87$0
Monthly Follow-up$37Included$57
Prescription SpeedSame day24-48 hoursSame day
Lab MonitoringRequiredOptionalRequired

I settled on the one that required labs — it shows they care about safety, not just prescribing volume.

Last edited: Jul 26, 2024 at 2:59 PM
50 0DebRD_ATL, KristenIndy, MarkLI_maint and 47 others
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Admin
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Jul 27, 2024 at 10:24 AM#15

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful.

Last edited: Jul 27, 2024 at 2:24 PM
49 24PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 46 others
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