Insurance and regulatory

Step therapy

The vocabulary of getting a claim paid, of FDA enforcement, and of what on-label and off-label really mean.

Definition

The insurer requiring you to fail a cheaper or older drug first. For GLP-1s that usually means Contrave or Qsymia before Wegovy or Zepbound. A legitimate cost-control tool and, in practice, one of the biggest access barriers in the class.

GLP-1 insurance coverage: Medicare, Medicaid, commercial

GLP Watchdog writes these definitions from FDA labels and peer-reviewed PubMed literature. Not one of them is an AI-generated summary.

Other terms under Insurance and regulatory

Where the evidence lives