NAVIGATING SAXENDA (LIRAGLUTIDE) COSTS: WHAT YOU NEED TO KNOW

Introduction:

Saxenda (liraglutide) is an injectable prescription medication for weight loss. It may be prescribed to people with obesity (BMI of 30 or higher) or to those who are overweight (BMI of 27 or higher) and have weight-related health conditions such as high blood pressure, high cholesterol, or type 2 diabetes. When combined with a reduced-calorie diet and exercise, clinical trials have shown that Saxenda users can lose between 5% and 10% of their body weight in one year. However, the cost of Saxenda can vary depending on insurance coverage and other factors. Let’s delve into the details.

How Much Does Saxenda Cost?

The list price for Saxenda is $1,349.02 for a 30-day supply. However, the actual cost may vary based on insurance coverage, pharmacy, and eligibility for savings or patient assistance programs. Additionally, disposable needles for Saxenda injections cost approximately $60 for a box of 100 needles.

Does Insurance Cover Saxenda?

Insurance coverage for Saxenda varies depending on the type of insurance plan. Private or commercial insurance may or may not cover Saxenda, and some plans may require prior authorization. Medicare typically does not cover weight loss medications, but coverage may be available through supplemental plans. Medicaid coverage varies by state, so it’s essential to check with the state Medicaid program. Veterans Administration (VA) and TRICARE may offer coverage for Saxenda under certain circumstances.

How to Get Insurance to Cover Saxenda:

If Saxenda is not covered by insurance, patients can work with healthcare providers to request coverage. Novo Nordisk provides sample letter templates for this purpose. Patients can also explore options through their employer’s benefits manager. Once the insurance plan deductible is met, patients may only be responsible for copays.

Saxenda Coupons and Savings Offers:

Novo Nordisk offers a Saxenda Savings card, which can save patients up to $200 per box of Saxenda for 12 months, bringing the cost down to $25 per box. However, eligibility requirements apply, and patients must have private or commercial insurance without Medicaid or Medicare coverage.

4 Ways to Reduce Saxenda Cost:

  1. Search for Saxenda Coupons: Patients can utilize Saxenda Savings Offers and may also find coupons at pharmacies or through online platforms like SingleCare and GoodRx.
  2. Purchase a 3-Month Supply: Buying a 90-day supply of Saxenda may be more cost-effective and convenient, with potential savings offered through the Saxenda Savings Offer.
  3. Shop Around at Pharmacies: Prices for Saxenda can vary between pharmacies, so patients should compare prices and consider mail-order or online pharmacies for potential savings.
  4. Consider Alternate Medications: Patients can discuss alternative weight loss medications with healthcare providers, such as Ozempic, Wegovy, or Mounjaro, which may offer comparable effectiveness at different price points.

Conclusion:

Navigating the cost of Saxenda can be complex, but with careful consideration of insurance coverage, savings offers, and alternative medications, patients can make informed decisions with the guidance of healthcare providers. It’s essential to explore all available options to ensure access to effective weight loss treatment while managing costs effectively.

Disclaimer:

If you have any medical questions or concerns, please consult your healthcare provider. The information provided here is for educational purposes and should not replace professional medical advice, diagnosis, or treatment. While based on peer-reviewed research and reputable sources, it is not a substitute for personalized healthcare guidance.

SOURCES:

  1. Pi-Sunyer, F. X., Astrup, A., Fujioka, K., Greenway, F., Halpern, A., Krempf, M., … & Liraglutide 3.0 mg Obesity Study Group. (2015). A randomized, controlled trial of 3.0 mg of liraglutide in weight management. New England Journal of Medicine, 373(1), 11-22.
  2. Centers for Medicare & Medicaid Services. (n.d.). Medicare Coverage of Obesity. Retrieved from https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=210&ncdver=3&bc=AAAAEAAAAAAAAA%3d%3d&.
  3. Novo Nordisk Inc. (n.d.). Saxenda® Savings Card Program. Retrieved from https://www.saxenda.com/saxenda-savings-card.html.
  4. Centers for Medicare & Medicaid Services. (n.d.). Medicaid State Plans. Retrieved from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=30106.
  5. Novo Nordisk Inc. (n.d.). Saxenda® Patient Assistance Program. Retrieved from https://www.novocare.com/saxenda/saxenda-patient-assistance.html.